Large Right Ventricular Hemangioma Presented as Acute Pulmonary Embolism at Two Weeks Post-COVID19 Vaccination: A Case Report

Background:
Right ventricular hemangioma is very rare. Corona Virus disease (COVID-19) and vaccination were documented to cause diverse thromboembolic phenomena.


Case presentation:
We report a large right ventricular hemangioma presented as acute pulmonary embolism two weeks after COVID-19 vaccination associated with acute kidney injury and significantly elevated Interleukin-6 (IL-6). There was no thrombocytopenia; therefore, the diagnosis of vaccine-induced immune thrombotic thrombocytopenia (VIIT) was deemed unlikely. The patient underwent emergency cardiac surgery. The mass was excised through a right atriotomy, and tricuspid annuloplasty was done. IL-6 normalized after six days with resolution of acute kidney injury.


Conclusions:
Pulmonary embolism is a rare presentation of the right ventricular hemangioma, and COVID-19 vaccination could play a role in this presentation. Cardiac hemangioma could be associated with high IL-6 that resolves with excision.