Worsening cardiac tamponade after pericardiocentesis in a patient with anterior mediastinum mass: a case report

Adi, Osman; Fong, Chan Pei; Ahmad, Azma Haryaty; Panebianco, Nova L.

doi:10.1093/ehjcr/ytac329

Cited by 2 publications

(1 citation statement)

References 20 publications

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“…Pericardiocentesis was done, and in a couple of hours, the patient succumbed to his illness. The swift removal of pericardial fluid further caused the mediastinal mass to compress the heart chambers, worsening his obstructive shock [ 21 ].…”

Section: Reviewmentioning

confidence: 99%

Iatrogenic Causes of Cardiac Tamponade Resulting From Surgical Procedures: An Overview

Alsenan¹,

Dhneem²,

Alfandi³

et al. 2023

Cureus

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Cardiac tamponade is one of the most severely life-threatening emergencies encountered, mainly because of its significant impact on the pumping capacity of the heart by compressing the cardiac chambers due to the rapid accumulation of blood, fluid, pus, or clots in the pericardial sac. These accumulations may be collected following traumas, malignancies, uremia, and many other medical conditions as well as surgical procedures. Numerous errors and medicolegal aspects have been identified in diagnosing and treating cardiac tamponade associated with cardiac-related procedures such as valve replacement surgeries, cardiac pacemaker implantation, pericardiocentesis, and other non-cardiac related procedures such as peri-hiatal surgeries. Patients taking anticoagulants or anticancer medications are especially susceptible to developing cardiac tamponade when undergoing surgical procedures, raising the question of preoperative screening to avoid errors. Misdiagnosis, treatment delay or failure to deliver the utmost quality of treatment, lack of complication screening and follow-ups for those at risk, surgeons rushing to complete cases, burnout, and other human factors are predispositions to the development of cardiac tamponade. Fortunately, most of these errors occurring within healthcare settings are avoidable and must be prevented for eliminating any risks to reduce the incidence and mortality of cardiac tamponade cases resulting from iatrogenic etiology. It is an intricate condition where precision and caution are crucial.

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Section: Reviewmentioning

confidence: 99%

Iatrogenic Causes of Cardiac Tamponade Resulting From Surgical Procedures: An Overview

Alsenan¹,

Dhneem²,

Alfandi³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

The Jack-in-the-Box: Pericardial Decompression Syndrome Managed by a Multidisciplinary Approach with Early Initiation of Veno-Arterial Extracorporeal Membrane Oxygenation: A Case Report

Orban,

Borjog,

Talpau

et al. 2024

Medicina

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Post decompression syndrome (PDS) is a rare and life-threatening complication of pericardiocentesis, especially after rapid drainage of large amounts of pericardial fluid. We present the case of a 21-year-old man who presented with cardiac tamponade of unknown etiology. After preoperative optimization, surgical drainage of the pericardial effusion was performed and approximately 2500 mL of fluid was released over 30 min. The patient rapidly developed hemodynamic collapse with severe biventricular dysfunction, with a left ventricle ejection fraction of 15%. Vasopressor and inotropic support were initiated with Noradrenaline and Dobutamine, further escalated to Adrenaline and Levosimendan with no improvement in clinical and hemodynamic parameters. Considering the high doses of vasoactive drugs, rescue veno-arterial extracorporeal membrane oxygenation (V-A ECMO) was started within the first 24 h. After 10 days on V-A ECMO, the cardiac function slowly recovered, and the extracorporeal mechanical support was successfully weaned. The diagnosis of paraneoplastic PDS secondary to angiosarcoma was made and the patient was successfully discharged to the ward on the 24th day. In conclusion, far from being the last option in the management of PDS, V-A ECMO deserves early consideration for securing adequate myocardial and systemic perfusion, while the cardiac function recovers, but a risk-to-benefit assessment should be made by an experienced multidisciplinary team.

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Worsening cardiac tamponade after pericardiocentesis in a patient with anterior mediastinum mass: a case report

Cited by 2 publications

References 20 publications

Iatrogenic Causes of Cardiac Tamponade Resulting From Surgical Procedures: An Overview

Iatrogenic Causes of Cardiac Tamponade Resulting From Surgical Procedures: An Overview

The Jack-in-the-Box: Pericardial Decompression Syndrome Managed by a Multidisciplinary Approach with Early Initiation of Veno-Arterial Extracorporeal Membrane Oxygenation: A Case Report

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