A Patient Presenting with Cardiac Tamponade and the Challenges of Finding Its Cause: A Cardiac Angiosarcoma

Abstract

Primary malignancies of the heart are so rare that most of the available data come from case reports or large single-center-based studies, with the overall incidence of 0.02% in the United States. Diagnosis in case of an isolated pericardial effusion as presentation is challenging, and determining that an angiosarcoma is even more challenging. Here, we presented a rare case of pericardial angiosarcoma which presented to us with tamponade. The patient eventually was diagnosed through pericardiectomy. A multimodality approach was attempted to treat the cancer. The clinical details of such a unique disease entity inspired us to present it as a case report.

An Innovative Approach to the Diagnosis of Cardiac Angiosarcoma

“…Pericardial effusion, dyspnea, chest pain, palpitations, and myalgia are common presenting complaints. Angiosarcoma can also be a rare etiology for cardiac tamponade [4,5].…”

Concomitant intravascular and extravascular obstructive shock: a case report of cardiac angiosarcoma presenting with pericardial tamponade

“…In some instances, clinicians may overlook primary cardiac masses as the underlying cause of a pericardial effusion. 13 The limited case reports that do exist suggest that the development of pericardial effusions are possible secondary to compromise of integrity of the atrial wall. 14,15 Nearly none of the previous literature discuss the relationship between both intravascular and extravascular obstructive shock secondary to a concomitant tamponade and intracardiac obstructive physiology.…”

“…To date, there are limited existing reports dealing with presentation of cardiac angiosarcomas with associated pericardial tamponade, and virtually no prior references in the emergency medicine literature. In some instances, clinicians may overlook primary cardiac masses as the underlying cause of a pericardial effusion [ 13 ]. The limited case reports that do exist suggest that the development of pericardial effusions are possible secondary to compromise of integrity of the atrial wall [ 14 , 15 ].…”