Cardiac Tamponade Associated with the Administration of Dicumarol

Abstract

The case history is presented of a man 22 years of age who develope(l cardiac tamponallde in association wAith anticoagulant therapy and nonp)enetrating trauma of the heart. Included is a commentar'y on the delayed appearance of signs indicative of pericardial and/or myocar(lial daniage following severe trauma and the value of serial electrocardiographic observations in the diagnosis thereof.The importance of interpretation of the results of prothrombin testing is discussed and comparative data are presented which indicate the desirability for standardization of methods employed in reporting prothrombin values when used to control anticoagulant therapy wsith dicuilnai'ol.

Experience with cardiac tamponade following open heart surgery

“…Thus, there may be an association between postpericardiotomy syndrome and cardiac tamponade in anticoagulated patients and, hence, it is interesting that postpericardiotomy syndrome is more common in patients undergoing valve surgery, particularly aortic valve surgery [21]. There is evidence that anticoagulant therapy increases the risk of hemopericardium, either spontaneously [27] or in association with pericarditis [28], and that intrapericardial blood, postoperatively, provokes pericardial irritation and a reactive effusion [23]. However, the precise role of the immune system in producing a pericardial effusion in response to tissue damage, concomitant viral infection, or other triggers remains poorly understood [29].…”