Malignant pleural/pericardial effusion with tamponade and life-threatening reversible myocardial depression in a case of an initial presentation of lung adenocarcinoma

Cardiology. 2006;105(1):30-3. doi: 10.1159/000088344. Epub 2005 Sep 19.

Abstract

We present a case of a middle-aged woman in cardiac tamponade. Following pericardiocentesis that removed 1,500 ml of hemorrhagic fluid, the patient exhibited cardiogenic shock; LVEF, at its nadir, on inotrope, was less than 20%. Ventricular function slowly improved, with inotropic support, to the normal range by the 25th day of hospitalization. Cardiac failure in malignancy has often been attributed to multi-system failure; this case showed a hereto unrecognized clinical phenomenon - 'malignancy-associated myopericarditis'. While the direct link of cause and effect cannot be made with certainty, the case should be instructive to other clinicians who encounter similar life-threatening presentations of cardiac decompensation in malignancy.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / physiopathology
  • Cardiac Tamponade / diagnosis*
  • Cardiac Tamponade / physiopathology
  • Female
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / physiopathology
  • Middle Aged
  • Pericardial Effusion / diagnosis*
  • Pericardial Effusion / physiopathology
  • Pleural Effusion, Malignant / diagnosis*
  • Pleural Effusion, Malignant / physiopathology
  • Stroke Volume
  • Ventricular Dysfunction, Left / diagnosis*
  • Ventricular Dysfunction, Left / physiopathology