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首页> 外文期刊>Case Reports in Cardiology >A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone
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A Rare Case of Spontaneous Cardiac Tamponade Induced by Concomitant Use of Rivaroxaban and Amiodarone

机译：同时使用利伐沙班和胺碘酮引起的自发性心脏填塞物罕见病例

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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.
机译：利伐沙班是一种直接口服抗凝剂（DOAC），被批准作为非瓣膜性心房颤动患者的华法林替代品。我们报道了一位87岁的男性患者，该患者在利伐沙班上有非瓣膜性心房颤动的病史，最近开始使用胺碘酮治疗无脉性室性心动过速，他因间歇性胸痛到我院就诊，并被诊断出自发性心包积压，导致心脏压塞。停止使用罪魁祸首药物，并对患者进行紧急心包穿刺术治疗。利伐沙班和胺碘酮均为CYP3A4肝途径的底物，并用会导致血浆利伐沙班水平升高，导致出血倾向增加。尽管大多数医师意识到利伐沙班需要肾脏给药，但本文旨在提高人们对其利伐沙班与也通过相同肝CYP450途径代谢的药物相互作用的认识。

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