Simultaneously diagnosed pulmonary thromboembolism and hemopericardium in a man with thoracic spinal cord injury

Abstract

Background: Simultaneous pulmonary thromboembolism (PTE) and hemopericardium is a rare but lifethreatening condition. As hemopericardium is a contraindication to anticoagulation treatment, it is challenging to handle both conditions together. Objective: The objective of the study was to report a rare case of a man with thoracic spinal cord injury presenting with simultaneous PTE and hemopericardium. Design: Case report. Subject: A 43-year-old man with incomplete T9 paraplegia (American Spinal Injury Association Impairment Scale D) complained of fever one and a half months after spinal cord injury sustained in a fall. Findings: During evaluation of fever origin, chest computed tomography and transthoracic echocardiogram revealed simultaneous PTE and hemopericardium. After serial echocardiograms over 2 days demonstrated stability, intravenous heparin, and oral warfarin were administered and his medical status was observed closely. Ultimately, both conditions improved without significant complications. Conclusion: We report successful treatment of man with acute spinal cord injury who presented with simultaneously diagnosed PTE and hemopericardium, a rare complication involving two distinct and opposing pathological mechanisms and conflicting treatments.

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.…”

Management of cardiac tamponade during catheter-directed thrombolysis of saddle pulmonary embolism: A clinical dilemma

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Pulmonary embolism with haemorrhagic pericardial effusion and tamponade: a clinical dilemma

“…Han et al 9 describe a recent case of simultaneous haemorrhagic pericardial effusion and PE presenting in a gentleman 1 month post-traumatic spinal cord injury. Han et al 's case differs by aetiology, being traumatic in nature and also because tamponade did not develop.…”