Pulmonary tumor embolism: a rare cause of acute right heart failure with elevated D-dimers.
We report the case of a 49-year-old woman with a prior history of breast cancer who presented with a subacute course of progressive dyspnoea, culminating in cardiovascular collapse from acute right heart failure. D-dimer serum level was elevated. While a computed tomography of the chest was negative for pulmonary embolism, the autopsy study revealed multiple carcinomatous emboli in distal pulmonary arteries, veins, and lymphatics. Pulmonary tumor embolism may be more frequent than previously thought, and could be mistaken for pulmonary thrombo-embolism.
Kridel
Robert
R
Department of Internal Medicine, Division of Oncology, Geneva University Hospitals, Geneva, Switzerland. robert.kridel@hcuge.ch
Myit
Samir
S
Pache
Jean-Claude
JC
Gaspoz
Jean-Michel
JM
D000230:Adenocarcinoma / Q000097:blood / Q000556:secondary*; D001344:Autopsy; D001943:Breast Neoplasms / Q000473:pathology; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology; D017809:Fatal Outcome; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D006333:Heart Failure / Q000097:blood / Q000209:etiology*; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000556:secondary*; D008205:Lymphangitis / Q000175:diagnosis / Q000209:etiology; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D011655:Pulmonary Embolism / Q000097:blood / Q000150:complications*; D011660:Pulmonary Heart Disease / Q000097:blood / Q000209:etiology*; D014057:Tomography, X-Ray Computed
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D