Cardiac Tamponade Associated with Rivaroxaban

Area of Science:

• Cardiology
• Pharmacology
• Internal Medicine

Background:

• Rivaroxaban is a widely used oral anticoagulant targeting Factor Xa, prescribed for stroke prevention and venous thromboembolic disease.
• Hemopericardium, a critical complication of anticoagulation, has been documented with various anticoagulant classes.
• Published reports of hemopericardium leading to cardiac tamponade specifically linked to Factor Xa inhibitors were absent prior to this case.

Observation:

• A patient undergoing treatment with Rivaroxaban developed pericarditis.
• This condition progressed to hemopericardium, resulting in cardiac tamponade.
• This represents a potential, serious adverse event associated with Rivaroxaban therapy.

Findings:

• The case details a rare instance of hemopericardium and tamponade in a patient treated with Rivaroxaban.
• The patient experienced pericarditis concurrently with Rivaroxaban treatment.
• This adverse event occurred despite Rivaroxaban's established safety profile for its approved indications.

Implications:

• This case underscores a significant adverse effect of newer oral anticoagulants like Rivaroxaban.
• It highlights the heightened risks associated with concomitant medication use, particularly in the elderly population.
• Clinicians should maintain vigilance for rare but severe complications of anticoagulants, including hemopericardium and tamponade, especially when managing polypharmacy in older adults.