A rare cause for acute cor pulmonale.
1Department of Medicine, Medical College Hospital, Thiruvanathapuram, India.
Case Reports in Gastroenterology
|June 30, 2011
Summary
Hepatocellular carcinoma (HCC) rarely spreads to the heart, causing a right atrial mass and pulmonary embolism. Early screening for liver disease patients is crucial for detecting HCC metastasis.
Area of Science:
- Cardiology
- Hepatology
- Oncology
Background:
- Primary cardiac tumors are rare, accounting for 0.002-0.25% of all tumors.
- Intracardiac metastasis of hepatocellular carcinoma (HCC) is exceptionally uncommon.
- Pulmonary embolism secondary to HCC is a rare clinical presentation.
Observation:
- A 32-year-old man with diabetes, alcoholism, and smoking history presented with shortness of breath and cough.
- Clinical diagnosis of pulmonary embolism was made, with echocardiogram revealing a right atrial mass.
- MRI confirmed a large right atrial mass extending into the inferior vena cava.
Findings:
- The patient had chronic liver disease, portal hypertension, and was hepatitis B surface antigen-positive.
- Pathological examination of the excised mass revealed metastatic HCC with pulmonary vascular emboli.
- This represents the second reported case of HCC metastasis presenting as a right atrial mass with pulmonary embolism.
Implications:
- Highlights the critical need for vigilant screening in patients with chronic liver disease and viral hepatitis.
- Suggests 6-monthly screening for early hepatocellular carcinoma (HCC) detection in high-risk populations.
- Emphasizes the importance of considering rare metastatic presentations of HCC in clinical diagnosis.
Keywords:
Acute cor pulmonaleAlpha-fetoproteinHepatitis B surface antigenHepatocellular carcinomaPulmonary thromboembolismRight atrial massMore Related Videos
07:02A Large Animal Model for Pulmonary Hypertension and Right Ventricular Failure: Left Pulmonary Artery Ligation and Progressive Main Pulmonary Artery Banding in Sheep
Published on: July 15, 2021
09:22Chronic Thromboembolic Pulmonary Hypertension and Assessment of Right Ventricular Function in the Piglet
Published on: November 4, 2015
Related Concept Videos
01:18Pulmonary Edema II: Pathophysiology
Pulmonary edema is the accumulation of fluid in the interstitial and alveolar spaces of the lungs, impairing gas exchange and oxygen delivery. It may be cardiogenic or noncardiogenic, but both reduce oxygenation and lung compliance.Cardiogenic Pulmonary EdemaCardiogenic edema results from increased hydrostatic pressure in pulmonary capillaries, usually due to left ventricular dysfunction from myocardial infarction, heart failure, or valvular disease. Ineffective cardiac pumping causes blood to...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
01:30Acute Respiratory Failure-III
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
01:17Pulmonary Cycle: Exhalation
In terms of human respiration, the act of expelling air, known as exhalation (or expiration), operates on the principle of pressure gradients. During expiration, the pressure within the lungs exceeds that of the surrounding atmosphere. Under normal conditions, quiet breathing involves passive exhalation and is free of muscular contractions. This is because the exhalation process is driven by the natural elastic recoil of the lungs and chest wall, both of which have an inherent tendency to...
01:23Chronic Obstructive Pulmonary Disease II: Emphysema
Emphysema, a major phenotype of chronic obstructive pulmonary disease (COPD), is characterized by irreversible destruction of alveolar walls and permanent enlargement of distal airspaces. Unlike chronic bronchitis, which primarily affects the airways, emphysema predominantly involves the lung parenchyma, where structural damage leads to airflow limitation.PathophysiologyIt most commonly results from prolonged exposure to cigarette smoke and other toxic gases, particularly cigarette smoke.
01:15Aortic Regurgitation I: Introduction
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...