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A bleeding disorder caused by a cardiac tumor: case report
L E Oostenbrug1, J P Ottervanger, E C Dompeling
1Department of Internal Medicine, University Hospital Groningen, Groningen, The Netherlands.
The Netherlands Journal of Medicine
|June 8, 2001
Summary
A rare case shows a cardiac tumor causing thrombocytopenia (low platelet count). Surgical removal of the papillary fibroelastoma normalized platelet levels, highlighting the importance of thorough physical exams.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Thrombocytopenia, characterized by low platelet counts, can present with various symptoms including easy bruising and ecchymoses.
- Cardiac tumors are rare, and their association with hematological disorders like thrombocytopenia is not well-established.
- Papillary fibroelastomas are the most common primary cardiac tumors, typically benign but can cause embolic events or symptoms due to mass effect.
Observation:
- A 22-year-old female presented with symptomatic thrombocytopenia and ecchymoses.
- Physical examination revealed a loud holosystolic murmur, prompting further investigation.
- Echocardiography identified an intracardiac tumor, later diagnosed as a papillary fibroelastoma.
Findings:
- The patient's thrombocytopenia was refractory to corticosteroid treatment.
- Surgical excision of the intracardiac papillary fibroelastoma led to the normalization of the platelet count.
- This case represents a unique presentation of thrombocytopenia secondary to a cardiac tumor.
Implications:
- This case highlights a potential, albeit rare, association between cardiac tumors and thrombocytopenia.
- It underscores the critical importance of a comprehensive physical examination, including auscultation for murmurs, in patients presenting with unexplained bleeding or bruising.
- Further investigation for intracardiac masses should be considered in cases of refractory thrombocytopenia with suggestive cardiac findings.