Initiation of sotatercept in a 21-year-old woman with Eisenmenger syndrome was associated with pericardial tamponade at 84 days, adding to 39 previously reported cases of associated effusion.
Case Report (n=1)
Is sotatercept associated with the development of pericardial effusion and tamponade in patients with Eisenmenger syndrome?
Sotatercept initiation in patients with complex physiologic states like Eisenmenger syndrome may be associated with the development of hemodynamically significant pericardial effusion and tamponade, warranting close surveillance.
ABSTRACT Eisenmenger syndrome (ES) represents an advanced stage of pulmonary arterial hypertension (PAH) associated with congenital heart disease. It is characterized by elevated pulmonary vascular resistance, with a right‐to‐left shunt and resting hypoxemia. ES is associated with high morbidity and mortality. Sotatercept, an activin‐signaling inhibitor recently approved for PAH, has demonstrated meaningful hemodynamic and clinical benefits; however, post‐approval experience has raised concern for an association with pericardial effusion. We report a 21‐year‐old woman with ES secondary to an unrepaired patent ductus arteriosus, who developed a hemodynamically significant pericardial effusion 84 days after initiating sotatercept. She presented with tamponade physiology requiring urgent pericardiocentesis and drain placement. An extensive evaluation revealed no obvious alternative etiology. A review of the published literature identified 39 cases of pericardial effusion associated with sotatercept, with more than half occurring in patients with connective tissue–associated PAH. This case highlights potential susceptibility in complex physiologic states such as ES and emphasizes the importance of close surveillance.
Aldawsari et al. (Wed,) conducted a case report in Eisenmenger syndrome (n=1). Sotatercept was evaluated on Pericardial effusion and tamponade. Initiation of sotatercept in a 21-year-old woman with Eisenmenger syndrome was associated with pericardial tamponade at 84 days, adding to 39 previously reported cases of associated effusion.