title: Cardiac tamponade as the first clinical sign of gastric adenocarcinoma: a rare condition.
abstract: Cardiac tamponade originating from a primary gastric cancer (GC) is a rare condition. Patients are generally asymptomatic until the disease is advanced. We report a rare patient with cardiac tamponade as the first manifestation of primary GC. A 46-year-old male was admitted with progressive dyspnea. Cardiac tamponade was diagnosed on two-dimensional ultrasonographic echocardiography. Pericardiocentesis yielded 1500 ml of bloody fluid. Pericardial cytologic examination was positive for malignant cells. The patient underwent abdominal computed tomography scan, which showed thickening of the gastric wall and several mesenteric lymph nodes. Endoscopic examination of the stomach disclosed malignant ulcer along the lesser curvature, and the biopsy showed diffuse type adenocarcinoma. Chemotherapy was initiated by the Oncology Department, and he had no pericardial effusion after six courses of systemic chemotherapy. In conclusion, this is a rare condition and difficult to diagnosis early. Thus, physicians should be aware of malignancy of the stomach when patients present with unexplained cardiac manifestations.
authors.affiliation: Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey. arfarsy@hotmail.com.
authors.forename: Arif
authors.initials: A
authors.lastname: Arısoy
authors.affiliation: Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey.
authors.forename: Kadriye
authors.initials: K
authors.lastname: Memiç
authors.affiliation: Department of Cardiology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Karavelioğlu
authors.affiliation: Department of Oncology, Hitit University Çorum Training and Research Hospital, Çorum, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Sen
mesh_terms: D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis*; D002305:Cardiac Tamponade / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D003937:Diagnosis, Differential; D004417:Dyspnea; D017548:Echocardiography, Transesophageal; D005221:Fatigue; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed