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Cardiac tamponade masking pulmonary embolism.
U C Jairath1, J R Benotti, D H Spodick
1Saint Vincent Hospital, Worcester, Massachusetts 01604, USA.
Clinical Cardiology
|June 14, 2001
Summary
A patient with colon cancer experienced shortness of breath due to cardiac tamponade, which hid a pulmonary embolism. The embolism was only found after treatment for cardiac tamponade failed to improve right heart pressures.
Area of Science:
- Cardiology
- Oncology
- Pulmonology
Background:
- Cardiac tamponade and pulmonary embolism are critical conditions that can present with similar symptoms, such as shortness of breath.
- Metastatic cancer can lead to various complications, including pericardial effusion and deep vein thrombosis.
Observation:
- A patient presented with shortness of breath, initially attributed to cardiac tamponade.
- Following pericardiocentesis, a procedure to drain fluid from around the heart, the patient's right heart pressures did not decrease as expected.
- This lack of improvement prompted further investigation, revealing a concomitant pulmonary embolism.
Findings:
- The patient was diagnosed with widely metastatic adenocarcinoma of the colon.
- Metastases were found in the pericardium, causing the cardiac tamponade.
- A paraneoplastic syndrome of deep vein thrombosis was also identified, linked to the colon cancer.
Implications:
- This case highlights the importance of considering multiple potential diagnoses in patients with complex presentations.
- It underscores how one critical condition (cardiac tamponade) can mask another (pulmonary embolism).
- The findings emphasize the diverse systemic effects of metastatic colon cancer, including cardiovascular and thromboembolic complications.