ArticleEuropean heart journal. Case reports2025
Pulmonary tumour thrombotic microangiopathy: case report of a rare cause of right ventricular acute pressure overload.
Article in European heart journal. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Pulmonary tumour thrombotic microangiopathy is a rare complication observed in patients with cancer, causing mainly progressive but sometimes acute pulmonary hypertension. Case summary: A patient with a recent transcatheter aortic valve implantation and a localized urothelial carcinoma on the urinary bladder presented with acute pressure overload of the right ventricle which led to refractory shock resulting in death. The initial suspicion was pulmonary thromboembolism, but he was finally diagnosed with tumour thrombotic microangiopathy at autopsy. Discussion: Pulmonary tumour thrombotic microangiopathy can lead to an abrupt clinical picture of respiratory failure and shock, similar to pulmonary thromboembolism, but with a completely different aetiology. Unfortunately, the diagnosis is usually made at autopsies. This case illustrates a rare but important cause in the differential diagnosis of acute pressure overload in the right ventricle, especially in patients with known malignancy.
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