Page 14 - Delaware Medical Journal July 2015
P. 14
Cardiac Tamponade Associated with Rivaroxaban
Stephen Boone, MD
Rivaroxaban is an oral anticoagulant approved for prevention of stroke, as well as for the treatment and prevention of venous thromboembolic disease. Hemopericardium is a serious complication of anticoagulant use, which has been reported with oral vitamin-K antagonists and newer oral anticoagulants. At the time of this report, to my knowledge, there are no published reports of hemorrhagic effusion leading to tamponade associated with a Factor Xa Inhibitor.
I report a case of hemopericardium with associated tamponade in a patient who developed pericarditis while being treated with Rivaroxaban. The case highlights an important adverse effect of a newer anticoagulant, as well as the particular dangers of medication co-administration in the elderly.
Key Words: Rivaroxaban, hemopericardium, pericardial effusion
IntroductionRivaroxaban is an oral anticoagulant approved
for prevention of stroke and systemic embolism in patients with
prevention of deep vein thrombosis and pulmonary embolism. Hemopericardium is a serious complication of anticoagulant administration, which has been reported with oral vitamin-K antagonist therapy1 direct thrombin inhibitors,2 and a factor
Xa inhibitor.3 However, to my knowledge, non-traumatic hemopericardium leading to life-threatening tamponade has not yet been reported in association with a factor Xa inhibitor.
I am reporting a serious complication of hemopericardium and tamponade in a patient who developed pericarditis while being treated with Rivaroxaban.
CASE REPORT
to the emergency department with complaints of shortness of breath, cough, and pleuritic chest pain. He had been recently hospitalized for acute bronchitis and mild acute kidney injury. During that admission, the patient had an electrocardiogram,
Fluid build-up within Pericardial Sac
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Del Med J
| July 2015
| Vol. 87
| No. 7
Abstract
