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Year : 2013  |  Volume : 14  |  Issue : 4  |  Page : 179-181

Fatal acute right heart failure in gastric cancer patients

Department of Internal Medicine, Division of Cardiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea

Correspondence Address:
Doo-Il Kim
Department of Medicine, Inje University College of Medicine, Haeundae Paik Hospital, 1435 Jwa-dong, Haeundae-gu, Busan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1995-705X.126883

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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.

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