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Case Report
Pericardiocentesis in cardiac tamponade: A case for “Less is More”
1 Cardiology Fellow, Department of Cardiology, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
2 Consultant Cardiologist, Department of Cardiology, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
3 Consultant Radiologist, Department of Radiology, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
Address correspondence to:
M Imran Khan
Cardiology Fellow, St Vincent’s University Hospital, Elm Park, Dublin 4,
Ireland
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Article ID: 101091Z01MK2020
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How to cite this article
Khan MI, Al Sahali W, Quigley P, McCreery C, Dodd J, O’Hanlon R. Pericardiocentesis in cardiac tamponade: A case for “Less is More”. Int J Case Rep Images 2020;11:101091Z01MK2020.ABSTRACT
Introduction: Cardiac tamponade could be a life-threatening condition and immediate pericardiocentesis is the treatment of choice. Acute decompensated heart failure as a complication of pericardiocentesis is less well known. Understanding the pathophysiology of cardiac tamponade may give clues to understanding the etiology of this uncommon but life-threatening condition.
Case Report: A 53-year-old female underwent emergency pericardiocentesis for acute cardiac tamponade. Baseline echocardiography demonstrated a large global pericardial effusion with normal left ventricular dimensions and systolic function, and typical features of tamponade. The clinical situation improved considerably following the removal of 1.5 liters of pericardial fluid over a period of 15 minutes. Within 24 hours she developed acute decompensated heart failure (ADHF). Echocardiography demonstrated severe biventricular systolic dysfunction while cardiac magnetic resonance imaging showed wall motion abnormalities consistent with inverted Takotsubo cardiomyopathy. On medical therapy she recovered completely after three weeks.
Conclusion: Large volume pericardiocentesis may be a triggering mechanism for biventricular failure.
Keywords: Cardiac tamponade, Heart failure, Pericardiocentesis, Takotsubo cardiomyopathy
SUPPORTING INFORMATION
Author Contributions
M Imran Khan - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Wissam Al Sahali - Substantial contributions to conception and design, Drafting the article, Final approval of the version to be published
Peter Quigley - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Charles McCreery - Revising it critically for important intellectual content, Final approval of the version to be published
Jonathan Dodd - Acquisition of data, Analysis of data, Revising it critically for important intellectual content, Final approval of the version to be published
Rory O’Hanlon - Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 M Imran Khan et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
