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하대정맥혈전이 있는 간암환자에서 심초음파도로 진단한 우심장내 Tumor Emnolism

Other Titles
 Tumor Embolism of Right Heart Diagnosed with Echocardiogram in Patients of Hepatoma with Inferior Vena Cava Thrombus 
 장정화  ;  고신옥  ;  김종래  ;  강진경 
 Journal of Korean Society of Anesthesiologist (대한마취과학회지), Vol.29(3) : 442-446, 1995-09 
Journal Title
Journal of Korean Society of Anesthesiologist(대한마취과학회지)
Issue Date
Tumor embolism ; Pulmonary embolism ; Pulmonary artery catheter ; Echocardiogram
Pulmonary thromboembolism is a leading cause of morbidity and mortality. Many patients dying of pulmonary thromboembolism have serious underlying illness such as cancer and congestive heart failure. Cancer patients are prone to both thrombotic and tumor embolism. In cancer patients, tumor pulmonary embolism and thrombotic pulmonary embolism can be associated with dyspnea, cor pulmonale and pulmonary hypertension, We presented a female patient of 63 year-old age of a hepatoma with inferior vena cava thrombosis. She had been transferred to the intensive care unit in state of refractory hypoxemia with 100% oxygen inhalation. Perfusion scan showed 60.71% defect in right lung and 39.28% defect in left lower lung field. Heparin infusion was done with the impression of pulmonary embolism without effect. Initial hemodynamic data with insertion of pulmonary artery catheter showed that cardiac index, 1.62 L/minute/M², right atrial pressure, 28 mmHg, pulmonary capillary wedge pressure 14 mmHg. Cardiac index did not increase in spite of dobutamine and dopamine infusion. Right atrial pressure increased to 29 mmHg but pulmonary capillary wedge pressure was 11 mmHg with fluid administration. Echocardiogram revealed that mass, 7(8 cm of size, was in right heart in connection to inferior vena cave thrombus. Tumor embolism from hepatoma would be suspected in our patient, but we did not confirm that case with the biopsy or autopsy. Echocardiography with pulmoary artery catheter insertion would be helpful to diagnose the disease which was suspected of pulmonary embolism and tumor embolism in cancer patient. (Korean J Anesthesiol 1995; 29: 442∼446)
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Shin Ok(고신옥)
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