Cardiac tamponade in Hodgkin lymphoma: a clinical case

Abstract

Background. The incidence of Hodgkin lymphoma (HL) is 2.5 cases per 100,000 people/year, with a 5-year survival rate of 89%. Secondary cardiac involvement in HL occurs in about 25% of cases, usually due to tumor compression and transudate formation; however, cardiac tamponade remains a very rare phenomenon. Objective(s). Clinical case presentation of a young female patient diagnosed with Hodgkin lymphoma, complicated by secondary pericardial involvement and clinical-paraclinical signs of cardiac tamponade. Materials and methods. A 29-year-old woman hospitalized in ward no. V of the Institute of Cardiology. Clinical and paraclinical data were collected through patient interview and medical records. Performed investigations included: electrocardiography, echocardiography, chest X-ray, chest computed tomography (CT), biochemical and hematological tests. Results. Clinical: dyspnea on moderate exertion, retrosternal pressure, dry cough during exertion and in the supine position. Objective: pallor of the teguments, rhythmic heart sounds, HR 94 bpm, BP 120/70 mmHg, vesicular breath sounds, SpO₂ 98%. Paraclinical: Hb 123 g/L, WBC 9.4×10⁹/L, ESR 7 mm/h, CRP 18.09 U/L. Echocardiography showed a thickened pericardium, large pericardial effusion with signs of tamponade. Chest CT revealed a mediastinal mass invading the pericardium, aorta, pulmonary trunk, and right lung with bilateral pleural effusion and pericarditis. Treatment: Chemotherapy according to the ABVD regimen with repeated CT monitoring. Conclusion(s). Cardiac tamponade is a very rare complication of Hodgkin lymphoma that demands rapid diagnosis and urgent treatment. Early involvement of a multidisciplinary team and swift initiation of targeted therapy are essential to prevent fatal complications and improve patient outcomes.