Simultaneous pericardial tamponade and pulmonary embolism in a patient with metastatic malignancy

    Authors

    Keywords

    pulmonary embolism, cardiac tamponade, ovarian cancer

    DOI

    https://doi.org/10.15836/ccar2022.291

    Full Text

    Pericardial effusion with tamponade and pulmonary embolism as concomitant diseases are found almost exclusively in patients with cancer and pose a diagnostic and therapeutic dilemma ( 1 , 2 ). We present a case of a 73-years-old female patient with concomitant cardiac tamponade and pulmonary embolism. At initial presentation patient complained about progressive dyspnea and showed clinical signs of imminent cardiac tamponade with reduced blood pressure and tachycardia and the “electrical alternans” pattern in the electrocardiogram ( Figure 1 ). After initial pericardiocentesis, hemodynamic stability was obtained. Due to concomitant pulmonary embolism, therapeutic dose of heparin was initiated, without any hemorrhagic complication during hospitalization. Pericardial fluid analysis showed metastatic cells and ovarian cancer as a primary site was found on the CT scan. After discharge, treatment with direct oral anticoagulant (apixaban) was continued and chemotherapy with capacitabine was started. The patient is doing well on routine three-month follow up. ECG with “electrical alternans”.

    Cardiologia Croatica
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    Simultaneous pericardial tamponade and pulmonary embolism in a patient with metastatic malignancy

    Extended Abstract
    Issue9-10
    Published
    Pages291
    PDF via DOIhttps://doi.org/10.15836/ccar2022.291
    pulmonary embolism
    cardiac tamponade
    ovarian cancer

    Authors

    Nikola Kos*ORCIDSestre Milosrdnice University Hospital Centre, Zagreb, Croatia
    Karlo GolubićORCIDSestre Milosrdnice University Hospital Centre, Zagreb, Croatia
    Tonći BatinićORCIDSestre Milosrdnice University Hospital Centre, Zagreb, Croatia
    Mislav VrsalovićORCIDSestre Milosrdnice University Hospital Centre, Zagreb, Croatia

    Full Text

    Pericardial effusion with tamponade and pulmonary embolism as concomitant diseases are found almost exclusively in patients with cancer and pose a diagnostic and therapeutic dilemma ( 1 , 2 ). We present a case of a 73-years-old female patient with concomitant cardiac tamponade and pulmonary embolism. At initial presentation patient complained about progressive dyspnea and showed clinical signs of imminent cardiac tamponade with reduced blood pressure and tachycardia and the “electrical alternans” pattern in the electrocardiogram ( Figure 1 ). After initial pericardiocentesis, hemodynamic stability was obtained. Due to concomitant pulmonary embolism, therapeutic dose of heparin was initiated, without any hemorrhagic complication during hospitalization. Pericardial fluid analysis showed metastatic cells and ovarian cancer as a primary site was found on the CT scan. After discharge, treatment with direct oral anticoagulant (apixaban) was continued and chemotherapy with capacitabine was started. The patient is doing well on routine three-month follow up. ECG with “electrical alternans”.