Fatal acute right heart failure in gastric cancer patients

• Main Authors: Sang-Hoon Seol, Bo-Min Park, Han-Young Jin, Doo-Il Kim
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2013-01-01
• Series: Heart Views
• Subjects: D-dimer; gastric cancer; right heart failure
• Online Access: http://www.heartviews.org/article.asp?issn=1995-705X;year=2013;volume=14;issue=4;spage=179;epage=181;aulast=Seol

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare condition causing pulmonary artery hypertension and acute right heart failure in patients with cancer. However, chest computer tomography shows negative finding of pulmonary thromboembolism. Serum D-dimer level may be elevated. Echocardiography reveals a dilated right ventricle and feature of pulmonary artery hypertension. Establishing this diagnosis can be very difficult, and most cases are diagnosed during autopsy, although a history of cancer may be a predictor. PTTM should be considered in all patients with apparent pulmonary artery hypertension and elevated D-dimer level, particularly when the patient is known to have an underlying malignancy, especially adenocarcinoma and most of all, the clinical manifestation is very rapidly progressive.