title: Case report: cardiac tamponade resembling an acute myocardial infarction as the initial manifestation of metastatic pericardial adenocarcinoma.
abstract: Pericardial malignancies are uncommon, usually metastatic, linked to terminal oncology patients, and rarely diagnosed premortem. A very small number of patients will develop signs and symptoms of malignant pericardial effusion as initial clinical manifestation of neoplastic disease. Among these patients, a minority will progress to a life-threatening cardiac tamponade. It is exceedingly rare for a cardiac tamponade to be the unveiling clinical manifestation of an unknown malignancy, either primary or metastatic to pericardium. We present the case of a 50-year-old male who was admitted to the emergency department with an acute myocardial infarction diagnosis that turned out to be a cardiac tamponade of unknown etiology. Further studies revealed a metastatic pericardial adenocarcinoma with secondary cardiac tamponade. We encourage considering malignancies metastatic to pericardium as probable etiology for large pericardial effusions and cardiac tamponade of unknown etiology.
authors.affiliation: Houston Methodist Hospital, Houston, Texas.
authors.forename: Scott A
authors.initials: SA
authors.lastname: Scheinin
authors.affiliation: Houston Methodist Hospital, Houston, Texas.
authors.forename: Jose
authors.initials: J
authors.lastname: Sosa-Herrera
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000556:secondary*; D002305:Cardiac Tamponade / Q000175:diagnosis / Q000209:etiology*; D003951:Diagnostic Errors; D006338:Heart Neoplasms / Q000150:complications* / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology*; D010496:Pericardium / Q000473:pathology*; D011237:Predictive Value of Tests; D012307:Risk Factors
keywords: acute myocardial infarction; adenocarcinoma of pericardium; cardiac tamponade; malignant pericardial effusion; pericardium
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