The administration of anaesthesia to subjects with intracardiac lesions poses the potential for cardiac complications. Cardiac metastases should be identified in susceptible cases and transthoracic echocardiography performed to elucidate the nature of the cardiac lesions. We describe a case of an intracardiac metastasis in a 65-year-old subject with a small bowel tumour leading to intestinal perforation and presenting for surgical treatment. Oncological assessment of the situation, in conjunction with the anaesthetic risks, led to abandonment of surgery and palliative treatment.