Fatal massive and recurring pulmonary embolism followed by thrombocytopenia developed after heparin and warfarin treatment in a patient with metastatic breast cancer with an incidental large right atrial thrombus.
A thromboembolic complication such as pulmonary embolism in patients who had cancer and mobile thrombi in the heart is a rare but fatal complication. Surgical thromboembolectomy is considered as the classical treatment of choice. In case of inoperable patient, catheter-directed therapy may be an alternative treatment. We report an interesting case of metastatic breast cancer with a large and mobile right atrial thrombus complicated by a massive and subsequently recurring pulmonary embolism, followed by thrombocytopenia developed after heparin and warfarin treatment.
aDivision of Cardiology, Department of Internal Medicine bDepartment of Radiology, Soonchunhyang University Hospital, Seoul, South Korea.
Young Kyu
YK
Cho
Byoung-Won
BW
Park
Min Ho
MH
Lee
Min Su
MS
Hyon
Duk Won
DW
Bang
Yong Jae
YJ
Kim
D000328:Adult; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006325:Heart Atria; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012008:Recurrence; D013921:Thrombocytopenia / Q000139:chemically induced / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D013927:Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D014859:Warfarin / Q000009:adverse effects
D005343:Fibrinolytic Agents; D014859:Warfarin; D006493:Heparin