Acute Dyspnea in Bronchogenic Carcinoma: A Rare Cause
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 1
Abstract
Introduction: Among carcinomas, Bronchogenic carcinoma is a leading cause of cancer related deaths in the world. Malignancies like bronchogenic carcinoma, breast carcinoma, lymphoma etc can cause pericardial effusion in advanced stages. Pericardial effusion is rarely seen as an initial presenting symptom. Case report: Forty five year old female admitted with dyspnea and generalised weakness. On clinical assessment patient had pitting pedal oedema, hypotension, tachycardia and a solitary non tender left supraclavicular lymphnode. X-Ray chest s/o right upper zone consolidation with right sided pleural effusion with cardiomegaly. On USG bilateral pleural effusion with pericardial effusion was demonstrated. 2D Echo s/o massive pericardial effusion and cardiac tamponade. Immediate pericardiocentesis was done and pericardial fluid drained over next 2 days. On assessment of pericardial fluid, malignant cells were seen. CECT Chest s/o hyperdense mass lesion in right upper lobe with right sided pleural effusion with cardiomegaly. FNAC done from supraclavicular lymph node s/o metastatic adenocarcinoma. Patient was managed with diuretics, steroids and vasopressors followed by chemotherapy. Conclusion: Patient with pericardial tamponade should always be treated by pericardiocentesis and evaluated for possible etiology. It is rare for bronchogenic carcinoma to present primarily with cardiac tamponade.
Authors and Affiliations
Parvinder Singh, Sameer Singhal, Dinesh Mehta, Sachin Bansal
Keywords
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