Fatal acute pulmonary hypertension caused by pulmonary tumour thrombotic microangiopathy

Abstract Pulmonary tumour thrombotic microangiopathy (PTTM) presents as acute pulmonary hypertension and sudden cardiovascular collapse in individuals with adenocarcinoma, usually of the stomach. The illness follows a fulminant course often before the adenocarcinoma has become clinically apparent. F...

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Bibliographic Details
Published in:International journal of cardiology 2008-02, Vol.124 (1), p.e11-e13
Main Authors: Keenan, N.G, Nicholson, A.G, Oldershaw, P.J
Format: Article
Language:English
Subjects:
Adenocarcinoma
Adenocarcinoma - complications
Adenocarcinoma - secondary
Adult
Cardiovascular
Diagnosis, Differential
Echocardiography
Electrocardiography
Fatal Outcome
Humans
Hypertension, Pulmonary - diagnosis
Hypertension, Pulmonary - etiology
Lung - blood supply
Lung - pathology
Lung Neoplasms - complications
Lung Neoplasms - secondary
Male
Microcirculation - pathology
Pulmonary hypertension
Stomach neoplasms
Stomach Neoplasms - pathology
Thrombosis
Thrombosis - diagnosis
Thrombosis - etiology
Tomography, X-Ray Computed
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Summary:Abstract Pulmonary tumour thrombotic microangiopathy (PTTM) presents as acute pulmonary hypertension and sudden cardiovascular collapse in individuals with adenocarcinoma, usually of the stomach. The illness follows a fulminant course often before the adenocarcinoma has become clinically apparent. Frequently the diagnosis is made only at necropsy. The diagnosis can be made by pulmonary microvascular cytology, obtained through a wedged pulmonary artery catheter. No treatment has thus far been found to be of benefit. We present a typical case in which the diagnosis was not reached before death despite multiple investigations and review the literature.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2006.11.162