Pericardial tamponade and coexisting pulmonary embolism as first manifestation of non-advanced lung adenocarcinoma

Abstract

Pericardial effusion and pulmonary embolism are relatively common complications of malignancy and are uncommon as its initial manifestation. This report describes a case of a patient, who presented with this association, due to an underlying pulmonary adenocarcinoma. When a major pericardial effusion is associated with pulmonary hypertension, some echocardiographic signs may redress the diagnosis. This case emphasizes a challenge diagnostic which may be guided by high right ventricular pressure and on the other hand the importance of keeping both these conditions in mind when dealing with context of malignancy.

How bad can life be? A case of concurrent cardiac tamponade and pulmonary embolus

“…There are very few published cases of concurrent pericardial effusion and PE, with the majority of these cases due to underlying malignancy or trauma . Our case is unique as we have not identified a clear underlying cause for her pericardial effusion.…”

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

“…We performed the literature review and found 11 previously documented cases of pericardial effusion and pulmonary embolism as concomitant cancer complications from 2000 to 2022 [13][14][15][16][17][18][19][20][21][22][23].…”

“…Ten out of eleven patients had been diagnosed with malignancy only after simultaneous pre-sentation of PE and pericardial effusion and admission to the hospital [13][14][15][16][17][18][20][21][22][23]. The cooccurrence of pericardial effusion and PE should prompt clinicians to look for undiagnosed active malignancies.…”

“…Ten patients (91%) had pericardiocentesis or surgery during hospitalization [13][14][15][16][17][18][20][21][22][23]. Seven patients (64%) received treatment with anticoagulants.…”

An Elderly Man With Dyspnea and Chest Pain

“…To our review, all other prior case reports of a patient presenting with coexisting pericardial tamponade and massive PE were also in the setting of advanced malignancy. 17,18 Given his age and comorbidities, the patient and his family elected for no further treatment of his malignancy. His inotropes were gradually weaned and his vitals remained stable; he was discharged to hospice care after removal of his pericardial drain.…”