BACKGROUND Emergency medicine (EM) is a dynamic specialty that requires not only an acquisition of vast amounts of medical knowledge, but also the ability to prioritize and task switch efficiently and effectively to combat the chaos, high patient volume, and variable acuity within a given shift. Additionally, mounting pressures are placed on EM faculty to use less time to care for a larger volume of patients while increasing patient satisfaction scores, documentation, billing, and academic productivity. 1,2 All of these factors can make the emergency department (ED) a challenging environment for clinical
Minoxidil is a strong oral vasodilator that is used to treat patients with hypertension refractory to first-line medications. We report a case of minoxidil-associated subacute cardiac tamponade diagnosed by point-of-care ultrasound (POCUS) in a hypertensive patient. A 30-year-old male with a past medical history of poorly controlled hypertension (treated with minoxidil) and chronic kidney disease presented with 2–3 days of chest pain and shortness of breath with markedly elevated blood pressures. A point-of-care transthoracic echocardiogram revealed a massive pericardial effusion with sonographic tamponade physiology. We review the risk factors for developing pericardial effusions that progress to cardiac tamponade, the utility of diagnosing these patients by POCUS, and the incidence of patients who present with sonographic signs of cardiac tamponade without hypotension.
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