Imaging of pericardial compressive syndromes – cardiac tamponade in oncologic patients

Abstract

Cardiac tamponade is a state of hemodynamic compromise that results from heart compression by a variety of fac­tors and conditions, including tumoral pericarditis or tumor cardiac compression. The aim of this article is to evaluate and discuss the added value of CT imaging find­ings of impending cardiac tamponade in patients with tho­ra­cic and hematologic malignancies. We reviewed our data­base for a period of six years, between January 2015 and April 2021, and we selected five patients with cli­ni­cal, he­mo­dynamic state and CT imaging features of car­diac tam­po­nade in oncologic pathology, four of them diag­nosed with he­ma­to­logic malignancies. We included post­ra­dio­­­the­rapy pericardial complications in the case of one patient. Although echocardiography represents the modality of choice to diag­nose patients with suspected cardiac tam­po­na­de, com­pu­ted tomography can provide valuable and sup­ple­men­tary information regarding the extension of the tu­mo­ral peri­car­dial involvement or the type of pericardial effusion. Con­si­de­ring that the early diagnosis of an impending car­diac tam­po­nade and the treatment are crucial in preventing mor­ta­lity and poor outcomes, radiologists have an impor­tant role in recognizing this entity.