Abstract
We report a rare case of fatal cardiac tamponade attributed to coronary sinus thrombosis. An 83-year-old man was admitted to the hospital complaining of general fatigue. Laboratory examination revealed marked increase of atypical lymphoblastic cells in peripheral blood. CHOP therapy was started under the diagnosis of acute lymphoblastic leukemia. The patient died, however, of sudden cardiac arrest in the initial course of the chemotherapy. Autopsy revealed cardiac tamponade with markedly dilated and congested coronary vein induced by coronary sinus thrombosis. A condition similar to leukemia-related venous thromboembolic disease, combined with endothelial damage induced by leukemic infiltration, may cause this rare complication.
Highlights
Coronary sinus thrombosis (CST) is an unusual but serious complication of central venous catheter devices [1]
A rare case of fatal cardiac tamponade attributed to coronary sinus thrombosis in an 83-year-old man with acute lymphoblastic leukemia is described
Except for a very rare and spontaneous primary case [6], CST is usually initiated by endothelial damage after access to the right atrium through invasive cardiac procedures such as insertion of central venous lines, pacing wire, or coronary sinus catheterization [1,2]
Summary
Coronary sinus thrombosis (CST) is an unusual but serious complication of central venous catheter devices [1]. Not so common as rupture of the aneurysm of sinus of Valsalva, CST can cause pericardial tamponade leading to sudden death [4,5]. A rare case of fatal cardiac tamponade attributed to coronary sinus thrombosis in an 83-year-old man with acute lymphoblastic leukemia is described.
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