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A patient with lung cancer and increased right ventricular pressure – should all lung cancer patients be suspected of pulmonary embolism?

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Styczkiewicz K., Mędrek S., Adamowicz A., Styczkiewicz M.

2019

vol. 9

issue 2

45-50

Lung cancer is associated with an increased risk of venous thromboembolism, including pulmonary embolism. In some situations, clinical deterioration in patients with lung cancer accompanied by elevated pressure in the right ventricle, usually measured by commonly used echocardiography, may support the diagnosis of pulmonary embolism. However, there are many other causes of increased pressure in the right ventricle in such patients, for example: progression of cancer, pre-existing lung diseases, surgical resection of pulmonary tissue, pnemotoxicity of radiotherapy or concomitant diseases of the left heart. The article presents 2 clinical cases of patients with lung cancer, in which elevated pressure in the right ventricle was resulted from other causes and accompanied the progression of cancer, despite the clinical picture suggesting a pulmonary embolism. Increased pressure in the right ventricle and usually associated pulmonary hypertension, significantly worsen already poor prognosis of patients with lung cancer. The differential diagnosis should, therefore, take into account the whole clinical picture, excluding venous thromboembolism as an important cause of pulmonary hypertension, but also take into account other potential factors to be able to make the right diagnosis and implement optimal treatment as early as possible.

Tyrosine kinase inhibitors – should we worry about cardiovascular complications?

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Styczkiewicz K., Sawka D., Styczkiewicz M.

OncoReview

2017

vol. 7

issue 2

70-77

Small-molecular tyrosine kinase inhibitors constitute an effective therapeutic option in patients with hematologic malignancies and solid tumours. On the other hand, the significance of cardiovascular adverse events associated with their use is often emphasised. The events include arterial hypertension, heart failure, coronary disease/acute coronary syndromes, and long QT syndrome. The paper discusses the underlying mechanisms behind cardiovascular events associated with the treatment that involves tyrosine kinase inhibitors, and presents preventive and therapeutic options available in clinical practice. Awareness of the potential cardiovascular complications, regular follow-up, early diagnosis and initiation of appropriate treatment, combined with close collaboration with cardiology specialists, may enhance the benefits of long-term TKI therapy.

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2 OncoReview

1 2019

1 2017

2 Styczkiewicz K.

2 Styczkiewicz M.

1 Adamowicz A.

1 Mędrek S.

1 Sawka D.

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A patient with lung cancer and increased right ventricular pressure – should all lung cancer patients be suspected of pulmonary embolism?

Tyrosine kinase inhibitors – should we worry about cardiovascular complications?