Tag Archives: cardiac tamponade

Case A 21-year-old man with a background of trisomy 21, previous cardiac surgery and cardiac resynchronisation therapy-pacemaker (CRT-P) was admitted with a one-week history of pleuritic chest pain, dyspnoea and non-productive cough. Cardiac surgery and CRT-P implantation was undertaken in the Middle East, the precise details of which were unavailable. Admission chest radiograph (figure 1A) revealed features suggestive of coronavirus disease 2019 (COVID-19), which was confirmed on nasopharyngeal swab. Electrocardiography (ECG) revealed sinus tachycardia with biventricular pacing markers. Other than an elevated troponin T (225 ng/L; normal ra

Introduction Cardiac tamponade and myocardial infarction (MI) are rare as the initial presentation of a malignancy. Lung cancer is among the most common sites from which cardiac metastases arise.1,2 The majority of cases of neoplastic pericardial disease are not detected or diagnosed antemortem due to the usual lack of clinical symptoms.3 Cardiac metastases most commonly occur between ages 50 and 70 years, notably via lymphatic and haematogenous dissemination.4,5 Tumour cells also have the ability to activate the coagulation system causing a prothrombic or hypercoagulable state to develop throughout the course of malignancy.6 Case A 57-year-o

Case A 35-year-old man, with no past medical history, self-presented to the emergency department at 20:00 with sharp central chest pain across his sternum, worse on inspiration. This was associated with a temperature of 39.1°C and sweating, and had been preceded by a two-day history of viral head-cold symptoms. He had no history of foreign travel, headache, photophobia, or features suggestive of meningism. On examination he looked pale, but was comfortable and alert with a heart rate of 84 beats per minute and a blood pressure of 115/75 mmHg. Routine blood tests showed C-reactive protein (CRP) 39 mg/L, white blood cell count (WBC) 15.9 × 10

Introduction Pregnancy does not show any specific predisposition to pericardial diseases. The more common form of pericardial involvement in pregnancy is a benign mild pericardial effusion, the incidence of which increases with duration of pregnancy reaching about 40% by the third trimester, resolving uneventfully after delivery.1 Larger effusions should raise clinical concern for an infection, autoimmune disorder or malignancy, which occur sporadically in pregnancy. We report the case of a 34-year-old term pregnant woman who presented with a massive pericardial effusion with cardiac tamponade. Case A 34-year-old woman presented to the emerge

Case report A 72-year-old man was admitted to our hospital for asthenia and general malaise for a week. He had a history of alcoholism, hypertension, diabetes, dyslipidaemia and peripheral artery disease with stent implantation in both iliac arteries. Five days before, he was admitted to the emergency department for asthenia and was diagnosed with atrial fibrillation and secondary congestive heart failure. Therapy with enoxaparin and warfarin was initiated, added to his long-term treatment with aspirin, but his symptoms worsened. On arrival, an ECG was performed showing sinus tachycardia with a narrow QRS complex (figure 1). Echocardiography

Figure 1. (A) Subcostal two-dimensional echocardiogram showing a large pericardial effusion (PE) with collapse of the right ventricular (RV) free wall during diastole. (B) Doppler echocardiography demonstrating marked changes in left ventricular outflow tract velocity during respiratory fluctuations. (C, D) Agitated saline contrast within the pericardial space The patient underwent therapeutic subxiphoid pericardiocentesis guided by contrast echocardiography. Pericardiocentesis is not without risk, and complications include laceration of cardiac chamber or coronary artery, aspiration of ventricular blood, arrhythmias, pneumothorax and punctur

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