Differential Diagnosis for Pericardial Effusion plus Pulmonary Embolism
Single Most Likely Diagnosis
- Malignancy: This is often considered the single most likely diagnosis because various cancers can metastasize to both the pericardium and the lungs, leading to pericardial effusion and pulmonary embolism, respectively. Tumors such as lung, breast, and melanoma are known to cause such complications.
Other Likely Diagnoses
- Trauma: Both pericardial effusion and pulmonary embolism can occur after significant trauma. The trauma can directly cause pericardial injury leading to effusion and also increase the risk of venous thromboembolism, which can result in pulmonary embolism.
- Infections: Certain infections, such as tuberculosis or bacterial infections, can cause pericarditis leading to effusion and also increase the risk of thrombosis due to inflammation, potentially resulting in pulmonary embolism.
- Autoimmune Disorders: Conditions like systemic lupus erythematosus (SLE) can cause both pericardial effusion due to pericarditis and increase the risk of thrombosis, including pulmonary embolism, due to antiphospholipid syndrome.
Do Not Miss Diagnoses
- Pulmonary Arterial Hypertension: Although less common, pulmonary arterial hypertension can lead to right heart failure, which may cause pericardial effusion. The increased pressure and potential for thrombosis in the pulmonary arteries also increase the risk of pulmonary embolism.
- Disseminated Intravascular Coagulation (DIC): This condition can lead to both thrombosis (potentially causing pulmonary embolism) and bleeding (potentially causing pericardial effusion). It's a critical condition that requires prompt recognition and treatment.
Rare Diagnoses
- Lymphangioleiomyomatosis (LAM): A rare lung disease that can cause pulmonary embolism due to the potential for venous thromboembolism and can also lead to pericardial effusion, although this is less common.
- Sarcoidosis: While more commonly associated with pulmonary and lymph node involvement, sarcoidosis can rarely cause pericardial effusion and may also increase the risk of pulmonary embolism, especially if there is significant pulmonary involvement or if the patient has other risk factors for thrombosis.