Defying Occam's Razor: A Case of Pulmonary Embolism Masked By Cardiac Tamponade

Pathak, Vikas; Manivel, Vijay

doi:10.1016/j.jemermed.2021.09.020

Cited by 3 publications

(9 citation statements)

References 21 publications

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“…Four cases were associated with malignancy ( 7 - 10 ). Regarding the cause of hemodynamic deterioration, mechanisms A and B were identified in cases 1 and 2, respectively ( 7 , 8 ); however, the relevant mechanisms in the remaining three cases were undetermined ( 9 , 10 , 23 ).…”

Section: Discussionmentioning

confidence: 98%

“…In our case, we did not evaluate VTE immediately before pericardiocentesis; therefore, the mechanism responsible is unclear. However, an ECG carried out immediately af- (7,8); however, the relevant mechanisms in the remaining three cases were undetermined (9,10,23). The coexistence of cardiac tamponade and PTE may be underestimated because the presence of cardiac tamponade makes a PTE diagnosis challenging (24); both induce rightsided heart failure symptoms, including dyspnea, fatigue, tachycardia, hypotension, and jugular vein distention.…”

Section: Discussionmentioning

confidence: 99%

“…Both cardiac tamponade and PTE can cause obstructive shock. However, paradoxically, the increased right heart pressure due to PTE may have a protective effect on the tamponade physiology ( 9 ). In our case, we did not evaluate VTE immediately before pericardiocentesis; therefore, the mechanism responsible is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…Internal mammary artery fistulas, acute pulmonary edema, and purulent pericarditis are rarely reported (6). Complications that are not generally recognized may arise following pericardiocentesis in patients with car-diac tamponade concomitant with a hypercoagulable state, including malignant diseases (7)(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

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Precautions When Performing Pericardiocentesis in Patients with Cardiac Tamponade-complicated Malignancy: A Case Report and Review of the Literature

2023

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A 51-year-old woman who had previously undergone left mastectomy for left breast cancer accompanied by multiple metastasis experienced worsening dyspnea. Physical and imaging assessments of the hemodynamics suggested cardiac tamponade, and emergency pericardiocentesis was successfully performed. However, immediately after the procedure, the patient's condition deteriorated rapidly and showed pulseless electrical activity. Contrast-enhanced computed tomography with continuous mechanical support demonstrated massive thrombi in both pulmonary arteries. An abrupt decrease in the central venous pressure and an increase in the venous return following pericardiocentesis might result in the migration of a deep venous thrombus and fatal acute pulmonary thromboembolism.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Precautions When Performing Pericardiocentesis in Patients with Cardiac Tamponade-complicated Malignancy: A Case Report and Review of the Literature

2023

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“…The patient's general condition improved and she was discharged. However, due to the active cancer nadroparine should be continued for a III not specified survived [16] IV heparin died after pericardiocentesis [18] V heparin, and after 5 days low-molecular-weight-heparin enoxaparin sodium survived [19] VI heparin, and after novel oral anticoagulants survived [20] VII low-molecular-weight-heparin died after 3 months [23] prolonged time. Also patient will continue treatment with torasemide, omeprazole, and levothyroxine.…”

Section: Case Presentationmentioning

confidence: 99%

Simultaneous presentation of pulmonary embolism and pericardial effusion as complications of cancer: a case report

Ratautė,

Jonuškienė,

Burneikaitė

2023

Seminars in Cardiovascular Medicine

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Summary We report the case of a 62-year-old woman who was admitted to Vilnius University Hospital Santaros klinikos suffering from week-long shortness of breath during minimal physical activity. Computed tomography angiography and echocardiogram findings led to a diagnosis of pulmonary embolism and large pericardial effusion. The patient was previously diagnosed with a base of tongue cancer with lung metastasis. The patient received low-molecular-weight-heparin, and pericardiocentesis was performed. As a result, the patient’s general condition improved, and she was discharged from the hospital. In this case, pulmonary embolism and pericardial effusion coincided as complications of malignancy. The concurrent presentation of these conditions is rare and poses a clinical dilemma regarding the treatment, including anticoagulant therapy.

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Cardiac tamponade developing during Trousseau's syndrome with pulmonary embolism

Itakura,

Hakozaki,

Inoue

2023

JA Clin Rep

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Defying Occam's Razor: A Case of Pulmonary Embolism Masked By Cardiac Tamponade

Cited by 3 publications

References 21 publications

Precautions When Performing Pericardiocentesis in Patients with Cardiac Tamponade-complicated Malignancy: A Case Report and Review of the Literature

Precautions When Performing Pericardiocentesis in Patients with Cardiac Tamponade-complicated Malignancy: A Case Report and Review of the Literature

Simultaneous presentation of pulmonary embolism and pericardial effusion as complications of cancer: a case report

Cardiac tamponade developing during Trousseau's syndrome with pulmonary embolism

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