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• W2334717488 abstract "We evaluated a 22-year-old patient complaining of acute breathlessness and pretibial edema in relapsed and refractory acute lymphoblastic leukemia (ALL). The patient was under rituximab-cyclophosphamide, vincristine, dexamethasone, doxorubicin (R-HCVAD) alternating with R-rituximab, methotrexate-cytarabine (MTX-ARAC) chemotherapies and he had a pancytopenia including severe thrombocytopenia. On his physical examination: The heart rate was 120 beats/min with evidence of pulsus paradoxus and the blood pressure was 85/60 mmHg. The jugular venous pressure was elevated up to the angle of the jaw. The cardiac apex was ill-defined and heart sounds were faint. There was no murmur or pericardial friction rub. He had severe pretibial edema because of hypoalbuminemia and acute right ventricular dysfunction observed by echocardiography. Electrocardiography revealed a poor R wave progression in all precordial derivations and sinus tachycardia. Laboratory data showed haemoglobin of 9.2 g/dL, white blood cell (WBC) count of 2.8x10 K/ uL with 93% blast cells, platelet count of 5x103/uL. International Normalized Ratio (INR) was 2.94 and activated Partial Thromboplastin Time (aPTT) was 56 sec. Chest radiogram showed moderate right sided pleural effusion with a normal cardiothoracic index. Bedside echocardiography revealed a large pericardial effusion with gross cardiac oscillation and diastolic collapse of the right ventricle and atrium (Figure 1). Mitral inflow pattern changed in expirium more than 25% of inspirium values and tricuspid inflow pattern changed in inspirium more than 40% of expirium values. Vena cava size was 2.3 cm and there was no change with respiration, particularly during inspirium. Echocardiographic and clinical findings indicated cardiac tamponade. Despite treatment with R-HCVAD regimen, the patient had no reponse to the treatment and his clinical condition was deteriorated. Because of the patient’s hemodynamic instability, we Abstract Cardiac tamponade (CT) as a clinical manifestation of lymphomas is extremely rare. Although leukaemic infiltration of the pericardium is frequently observed at post-mortem, clinically evident cardiac tamponade is also rare. We present a case of cardiac tamponade complicating leukaemia. The patient had cardiac tamponade and severe thrombocytopenia during chemotherapy due to relapsed and refractory acute lymphoblastic leukemia (ALL). We experienced complete resolution of the pericardial effusion without any bleeding complications after urgent pericardiocentesis within 15 days after successful ibubrufen-colchicine therapy. The exciting feature of this paper is that rescue pericardiosentesis may be livesaving despite crucial states, such as severe thrombocytopenia. (JAEM 2012; 11: 188-9)" @default.
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• W2334717488 date "2011-10-01" @default.
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• W2334717488 title "Successful Pericardiocentesis for Cardiac Tamponade in a Patient with Thrombocytopenic Acute Lymphocytic Leukemia" @default.
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• W2334717488 doi "https://doi.org/10.5152/jaem.2011.052" @default.
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