Open AccessFatal acute right heart failure in gastric cancer patients
Author(s) -
Sang–Hoon Seol,
Bo-Min Park,
Han-Young Jin,
Doo-Il Kim
Publication year - 2013
Publication title -
heart views
Language(s) - English
Resource type - Journals
eISSN - 0976-5123
pISSN - 1995-705X
DOI - 10.4103/1995-705x.126883
Subject(s) - medicine , thrombotic microangiopathy , malignancy , pulmonary artery , cardiology , heart failure , pulmonary hypertension , autopsy , ventricle , cancer , pulmonary embolism , radiology , disease
Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare condition causing pulmonary artery hypertension and acute right heart failure in patients with cancer. However, chest computer tomography shows negative finding of pulmonary thromboembolism. Serum D-dimer level may be elevated. Echocardiography reveals a dilated right ventricle and feature of pulmonary artery hypertension. Establishing this diagnosis can be very difficult, and most cases are diagnosed during autopsy, although a history of cancer may be a predictor. PTTM should be considered in all patients with apparent pulmonary artery hypertension and elevated D-dimer level, particularly when the patient is known to have an underlying malignancy, especially adenocarcinoma and most of all, the clinical manifestation is very rapidly progressive.