A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone
Rivaroxaban is a direct oral anticoagulant (DOAC) approved as an important alternative to warfarin in patients with nonvalvular atrial fibrillation. We report the case of an 87-year-old man with past medical history of nonvalvular atrial fibrillation on rivaroxaban and recently started amiodarone fo...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2018/1650716 |
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| author | Oreoluwa Oladiran Jared Segal Ifeanyi Nwosu Salik Nazir |
| author_facet | Oreoluwa Oladiran Jared Segal Ifeanyi Nwosu Salik Nazir |
| author_sort | Oreoluwa Oladiran |
| collection | DOAJ |
| description | Rivaroxaban is a direct oral anticoagulant (DOAC) approved as an important alternative to warfarin in patients with nonvalvular atrial fibrillation. We report the case of an 87-year-old man with past medical history of nonvalvular atrial fibrillation on rivaroxaban and recently started amiodarone for pulseless ventricular tachycardia who presented to our hospital with intermittent chest pain and was diagnosed with spontaneous hemopericardium causing cardiac tamponade. The culprit drugs were discontinued, and the patient was treated with emergent pericardiocentesis. Both rivaroxaban and amiodarone are substrates for the CYP3A4 hepatic pathway, and concomitant use can result in increased plasma rivaroxaban levels causing an increased propensity to bleeding. While most physicians are cognizant of the need for renal dosing of rivaroxaban, this article aims to increase awareness of its interactions with drugs that are also metabolized through the same hepatic CYP450 pathway. |
| format | Article |
| id | doaj-art-25f9b7d909e6438786a692acb9a20cd1 |
| institution | Kabale University |
| issn | 2090-6404 2090-6412 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-25f9b7d909e6438786a692acb9a20cd12025-02-03T06:00:20ZengWileyCase Reports in Cardiology2090-64042090-64122018-01-01201810.1155/2018/16507161650716A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and AmiodaroneOreoluwa Oladiran0Jared Segal1Ifeanyi Nwosu2Salik Nazir3Reading Hospital, Tower Health System, Reading, PA, USAReading Hospital, Tower Health System, Reading, PA, USABenenden Hospitals Trust, Kent, UKReading Hospital, Tower Health System, Reading, PA, USARivaroxaban is a direct oral anticoagulant (DOAC) approved as an important alternative to warfarin in patients with nonvalvular atrial fibrillation. We report the case of an 87-year-old man with past medical history of nonvalvular atrial fibrillation on rivaroxaban and recently started amiodarone for pulseless ventricular tachycardia who presented to our hospital with intermittent chest pain and was diagnosed with spontaneous hemopericardium causing cardiac tamponade. The culprit drugs were discontinued, and the patient was treated with emergent pericardiocentesis. Both rivaroxaban and amiodarone are substrates for the CYP3A4 hepatic pathway, and concomitant use can result in increased plasma rivaroxaban levels causing an increased propensity to bleeding. While most physicians are cognizant of the need for renal dosing of rivaroxaban, this article aims to increase awareness of its interactions with drugs that are also metabolized through the same hepatic CYP450 pathway.http://dx.doi.org/10.1155/2018/1650716 |
| spellingShingle | Oreoluwa Oladiran Jared Segal Ifeanyi Nwosu Salik Nazir A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone Case Reports in Cardiology |
| title | A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone |
| title_full | A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone |
| title_fullStr | A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone |
| title_full_unstemmed | A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone |
| title_short | A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone |
| title_sort | rare case of spontaneous cardiac tamponade induced by concomitant use of rivaroxaban and amiodarone |
| url | http://dx.doi.org/10.1155/2018/1650716 |
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