Key result
Rivaroxaban linked to spontaneous hemorrhagic cardiac tamponade within 10 days in a single AF patient.
Why the study?
There is a need for larger clinical trials and consensus guidelines on monitoring novel oral anticoagulants and developing reversal agents for major bleeding events.
Case Report (n=1)
Rivaroxaban use can be associated with spontaneous, life-threatening hemorrhagic cardiac tamponade requiring urgent pericardiocentesis.
May signal rare rivaroxaban-associated tamponade in AF; single case leaves open incidence and risk-factor questions.
Bleeding is the most feared complication of anticoagulants. Rivaroxaban is a newer oral anticoagulant with a favorable regimen due to lack of frequent blood monitoring and fewer drug interactions. We report a case of spontaneous pericardial hemorrhage associated with rivaroxaban. Within 10 days of starting rivaroxaban for atrial fibrillation, the patient developed a life-threatening cardiac tamponade leading to shock and multiorgan failure. After urgent pericardiocentesis/drainage, the patient recovered. This case highlights the necessity of larger clinical trials and consensus guideline on monitoring the effects of novel oral anticoagulants and development of an antidote for reversal in cases of major bleeding events.
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Kham et al. (2015) conducted a case report in Atrial fibrillation (n=1). Rivaroxaban was evaluated on Spontaneous pericardial hemorrhage. Rivaroxaban use for atrial fibrillation was associated with the development of life-threatening spontaneous hemorrhagic cardiac tamponade within 10 days of initiation in a single patient.
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