Cardiac tamponade as the initial manifestation of pulmonary adenocarcinoma

Letonja, Mitja; Debeljak, A

doi:10.2478/v10019-007-0025-6

Cited by 6 publications

(14 citation statements)

References 8 publications

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“…Pericardial effusion in malignancy patients is rather common. However, it usually involves terminally ill subjects with established diagnosis [10]. It is estimated that even up to 15-20% of them have metastases to the pericardium via either direct cancer extension or lymphatic and hematogeous routs [11].…”

Section: Discussionmentioning

confidence: 99%

Cardiac tamponade – unusual clinical manifestation of undiagnosed malignant neoplasm

Perek¹,

Tomaszewska²,

Stefaniak³

et al. 2016

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Cardiac tamponade may be the first or predominant symptom of some pathologies but its etiology is not uncommonly unknown on admission to hospital. The purpose of this study was to evaluate the predominant causes of cardiac tamponade in previously healthy patients treated emergently in a single cardiac surgical center. The study involved 81 patients with the mean age of 58.1±16.0 years who underwent emergent subxyphoid pericardiotomy due to cardiac tamponade. Pericardial effusion was analyzed macro- and microscopically. Examinations done in the cardiac surgical department revealed pericarditis secondary to infection (n=17) or autoimmunologic processes (n=2) and malignancy in 18 patients (predominantly of the lungs (n=11)). Pericardial effusion obtained from patients with viral and autoimmunologic-induced pericarditis was straw-color and odorless while with bacterial infections dark yellow, iridescent and usually malodorous. Additional workup in the regional hospitals enabled to reveal malignant tumors in 29 patients, leukemia or lymphoma in 5 subjects. In all but one of the neoplastic cases, pericardial fluid was turbid and dark red or plummy. In 10 patients etiology of tamponade remained unknown. In conclusion, cardiac tamponade in previously healthy patients may be occasionally the predominant symptom of cancer, especially of the lungs. Macroscopic intraoperative appearance of pericardial fluid may be helpful in identification of causative condition of cardiac tamponade.

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Section: Discussionmentioning

confidence: 99%

Cardiac tamponade – unusual clinical manifestation of undiagnosed malignant neoplasm

Perek¹,

Tomaszewska²,

Stefaniak³

et al. 2016

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“…Pericardiocentesis may be life-saving and brings about immediate symptomatic relief in 90% of patients as well as provide fluid for diagnosis 13. There is only 1% risk of major complications,13 which include puncturing of the coronary artery or myocardium, arrhythmias or pneumothorax 14.…”

Section: Discussionmentioning

confidence: 99%

“…There is only 1% risk of major complications,13 which include puncturing of the coronary artery or myocardium, arrhythmias or pneumothorax 14. Guided by echocardiography, this is a relatively safe and effective procedure 15…”

Section: Discussionmentioning

confidence: 99%

Recurrent cardiac tamponade: an initial presentation of lung adenocarcinoma

Kumar

Puttanna

2014

BMJ Case Reports

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A 63-year-old hypertensive woman presented initially to the surgical team with right upper quadrant pain, the patient was otherwise asymptomatic and clinically well. An abdominal CT scan excluded any surgical diagnoses but rather showed a pericardial effusion. When the cardiology team urgently reviewed her, they found her to be hypotensive and tachycardic with a raised jugular venous pressure. A diagnosis of cardiac tamponade was made and was transferred to the coronary care unit for an emergency pericardiocentesis. She developed tamponade on further occasions requiring pericardiocentesis. The underlying cause was investigated and following pericardial fluid analysis and subsequent imaging, metastatic lung adenocarcinoma was diagnosed.

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“…In rare cases, pericardial effusion is the initial manifestation of malignancy, and the first review of 29 isolated cases of cancer first manifested with pericardial effusion was published by Fraser in 1974 (11,12). Reports of cardiac tamponade as an initial presentation of malignancy are even much less prevalent, but we report a patient with cardiac tamponade as the first manifestation of lung cancer, although the occurrence of malignant cardiac tamponade is underestimated due to non-specific signs and symptoms (13,14). Acute dyspnea is the most commonly presented symptom in a review of malignant tamponade pooling several series with an incidence of 78%.…”

Section: Clinical Picturementioning

confidence: 94%

“…On physical examination the most frequently detected findings are sinus tachycardia (50%), jugular venous distention (45%), hepatomegaly (36%) and peripheral edema (35%). Classical findings of pericardial tamponade such as pulsus paradoxus, pericardial rub and Kussmaul's sign -occurred in only 30%, 12% and 5%, respectively (13)(14)(15). Despite the assumption that patient presented with tamponade have a worse prognosis than the patient with pericardial effusion without tamponade, no data are available to allow the stratification of the prognosis based on clinical presentation.…”

Section: Clinical Picturementioning

confidence: 99%