title: Spontaneous, Life-Threatening Hemorrhagic Cardiac Tamponade Secondary to Rivaroxaban.
abstract: Bleeding is the most feared complication of anticoagulants. Rivaroxaban is a newer oral anticoagulant with a favorable regimen due to lack of frequent blood monitoring and fewer drug interactions. We report a case of spontaneous pericardial hemorrhage associated with rivaroxaban. Within 10 days of starting rivaroxaban for atrial fibrillation, the patient developed a life-threatening cardiac tamponade leading to shock and multiorgan failure. After urgent pericardiocentesis/drainage, the patient recovered. This case highlights the necessity of larger clinical trials and consensus guideline on monitoring the effects of novel oral anticoagulants and development of an antidote for reversal in cases of major bleeding events.
authors.affiliation: 1Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL; and 2Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, IL.
authors.forename: Nang Mo
authors.initials: NM
authors.lastname: Kham
authors.forename: Mingchen
authors.initials: M
authors.lastname: Song
mesh_terms: D001281:Atrial Fibrillation / Q000188:drug therapy; D002305:Cardiac Tamponade / Q000139:chemically induced* / Q000150:complications; D065427:Factor Xa Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069552:Rivaroxaban / Q000009:adverse effects* / Q000627:therapeutic use; D012769:Shock / Q000209:etiology
chemical_list: D065427:Factor Xa Inhibitors; D000069552:Rivaroxaban