Cor Vasa 2008, 50(10):399-402 | DOI: 10.33678/cor.2008.140

Right heart failure as the first presentation of a malignancy

Iva Kociánová^1,*, Zuzana Moťovská¹, Blanka Rosová²

¹ III. interní-kardiologická klinika, Kardiocentrum

² Ústav patologie, Fakultní nemocnice Královské Vinohrady a 3. lékařská fakulta Univerzity Karlovy, Praha, Česká republika

This case report raises the question whether abdominal ultrasound belongs to standard diagnostic methods in patients with right heart failure of unknown etiology.
A 79-year-old man was admitted to hospital because of progressive dyspnea and symptoms of right heart failure. Echocardiography demonstrated preserved left ventricular systolic function and pulmonary hypertension. The patient died on day 9 of hospitalization of fulminant right heart failure. Autopsy revealed papillary renal cell carcinoma in the right kidney. Microscopic examination of the lungs discovered disseminated tumor emboli within the small branches of the pulmonary artery. Pulmonary tumor microembolism is a well-characterized cause of morbidity and mortality in cancer patients. Failure to recognize this condition before death is common. Abdominal ultrasound is a noninvasive, readily available, and inexpensive method. By visualizing a malignancy, this method could substantially improve the diagnostic process and have a beneficial impact on the outcome.

Keywords: Right heart failure; Pulmonary hypertension; Pulmonary tumor microembolism

Published: October 1, 2008  Show citation