RARE CASE OF SPONTANEOUS HEMOPERICARDIUM IN A PATIENT RECEIVING APIXABAN: CASE REPORT

Apixaban is a new oral anticoagulant (NOAC) available since 2012, indicated particularly for the prevention of embolic events in patients with non-valvular atrial fibrillation [1]. It is a direct inhibitor of factor Xa, with a half-life of around 12 hours. This new anticoagulant is associated with a lower risk of bleeding than vitamin K antagonists (VKAs) such as warfarin and requires less monitoring [2]. However, several recently published cases have demonstrated a correlation between Apixaban and the occurrence of pericardial effusion. We report the case of a 75-year-old hypertensive man diagnosed with atrial fibrillation 3 months ago, treated with Apixaban 5mg twice daily. He presented to the emergency department with rapidly worsening dyspnea, and echocardiography revealed a large pericardial effusion requiring drainage. A full etiological work-up was carried out, revealing no underlying pathology or triggering event to explain his pericardial effusion. We believe that his recently introduced anticoagulant therapy is the true cause.