Fatal acute right heart failure in gastric cancer patients.
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.
Department of Internal Medicine, Division of Cardiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
Sang-Hoon
SH
Seol
Department of Internal Medicine, Division of Cardiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
Bo-Min
BM
Park
Department of Internal Medicine, Division of Cardiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
Han-Young
HY
Jin
Department of Internal Medicine, Division of Cardiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
Doo-Il
DI
Kim
D-dimer; gastric cancer; right heart failure