Cardiac Tamponade Presenting as Abdominal Pain and Being the Initial Manifestation of Malignant Disease: A Case Report

Abstract

Neoplastic pericarditis can be presented as acute pericarditis, pericardial effusion, effusive constrictive pericarditis or cardiac tamponade. For the majority of patients, a clinical manifestation of neoplastic pericarditis is absent or remains unrecognised during their life. A 56 year old male asymptomatic until three days ago that began with intense pain in epigastric region. The yugular vein was distended, breath and heart sounds were slightly decreased. Right-sided abdominal pain especially pronounced in the epigastric and right iliac fossa, his liver was palpable 2 cm below the right costal margin. In first cut of abdominal CT we showed pericardial effusion. The patient improved immediately after thetherapeutic pericardiocentesis. For the study of primary tumor was performed a thoraco-abdominal CT. Showing right hiliar mass, mediastinal lymph nodes, bilateral lung metastases. The patient was diagnosed with stage IV lung carcinoma, initiated the chemotherapy treatment (carboplatin-gemcitabine) by the medical oncology service at our hospital. Cardiac tamponade as the initial manifestation of malignancy is rare and such patients have a very limited expectancy, is because at the time of tumor disease diagnosis it is already advanced. There are few reported cases of patients with pericardial tamponade who presented with abdominal pain.




J Med Cases. 2013;4(7):488-490
doi: http://dx.doi.org/10.4021/jmc1213w