Elevated CA 125 and ascites: not always malignancy.

Background: We present two clinical cases from a single institution where a final diagnosis of cardiac failure was made following the initial finding of ascites and an elevated CA 125 level. In both cases gynaecological malignancy was initially suspected.
Methods: Following negative confirmatory tests for gynaecological malignancy, echocardiography was undertaken.
Results: Patient 1 had severe right ventricular dilatation and dysfunction. Patient 2 had biventricular dysfunction with pulmonary hypertension. Both patients responded to standard therapy for heart failure, including loop diuretics.