Beyond Beck's Triad: A Rare Cause of Cardiac Tamponade and Hemoptysis
Background:
Primary cardiac angiosarcoma (CAS) is a rare tumor with a dismal prognosis. Many patients present with noncardiac symptoms related to metastatic disease that could delay the diagnosis and deteriorate the outcome.
Case Report:
A 36-year-old male presented with hemoptysis. Initial imaging and biopsies were inconclusive, but a repeat transthoracic echocardiogram to evaluate the patient's pericardial effusion showed a mass inferior to the right atrium and invading the wall. Biopsy results from 3 different sites confirmed the diagnosis of CAS. However, the patient's course was complicated with respiratory failure that ultimately led to his death. Autopsy demonstrated CAS involving the full thickness of the right atrium and pericardial tissue, with a diffuse metastatic process involving the lung, brain, and stomach.
Conclusion:
The case highlights the importance of having an increased level of suspicion for cardiac malignancy among young patients presenting with noncardiac symptoms.
Abstract
Background:
Primary cardiac angiosarcoma (CAS) is a rare tumor with a dismal prognosis. Many patients present with noncardiac symptoms related to metastatic disease that could delay the diagnosis and deteriorate the outcome.
Case Report:
A 36-year-old male presented with hemoptysis. Initial imaging and biopsies were inconclusive, but a repeat transthoracic echocardiogram to evaluate the patient's pericardial effusion showed a mass inferior to the right atrium and invading the wall. Biopsy results from 3 different sites confirmed the diagnosis of CAS. However, the patient's course was complicated with respiratory failure that ultimately led to his death. Autopsy demonstrated CAS involving the full thickness of the right atrium and pericardial tissue, with a diffuse metastatic process involving the lung, brain, and stomach.
Conclusion:
The case highlights the importance of having an increased level of suspicion for cardiac malignancy among young patients presenting with noncardiac symptoms.
ACKNOWLEDGMENTS
The authors have no financial or proprietary interest in the subject matter of this article.
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