Gastropericardial fistula presenting as acute cardiac tamponade. A case report

A case of acute cardiac tamponade due to perforation of a benign gastric ulcer into the pericardium is presented. A high index of suspicion, early diagnosis and prompt surgical intervention resulted in a favourable outcome in this otherwise uniformly fatal condition.     

Spontaneous chylous cardiac tamponade: a case report

Background  

Chylous cardiac tamponade is a rare condition with little known cause.     

Air tamponade. A case report

A 29-year-old man with post-traumatic cardiac tamponade resulting from the development of a tension pneumopericardium is described. To our knowledge this is the first such case reported in the literature.     

Recurrent cardiac tamponade after replacement of three heart valves. A case report.

Delayed pericardial effusion and cardiac tamponade are rare late complications of open-heart surgery. A case after replacement of all three heart valves with the Bj?rk-Shiley tilting disc valves with an unusual clinical course is presented in the following. Unsuccessful subsequent medical treatment, subsequent surgical intervention and its results are described and discussed. The need of further reports on similar observations is emphasized.     

Delayed cardiac tamponade after blunt chest trauma: case report

A case of cardiac tamponade without evidence of hemopericardium within 2 weeks after blunt chest trauma is reported. The cause was a pericardial effusion that may have resulted from the post-cardiac injury syndrome. Pericardiotomy drained 600 mL of straw-colored clear fluid. A high index of suspicion for cardiac tamponade must be maintained in such patients for weeks after injury.     

Emergent surgical treatment for purulent pericarditis associated with cardiac tamponade; report of a case

We describe a case of purulent pericarditis presented with cardiac tamponade. A 65-year-old man was admitted to our hospital with shock by cardiac tamponade and high grade fever. Transthoracic echocardiography revealed a large amount of pericardial effusion. Surgical drainage via median sternotomy was carried out in an emergent manner. Because culture of pericardial effusion showed positive for methicillin sensitive Staphylococcus aureus and thick white purulence covering over all pericardium, purulent pericarditis was diagnosed. Postoperative course was uneventful and discharged in a good condition. Special care should be taken of purulent pericaditis in differential diagnosis of cardiac tamponade.     

Pericardioperitoneal shunt for persistent pericardial effusions: a new drainage procedure.

We report a pericardioperitoneal shunt procedure in 2 patients with persistent pericardial effusions in which the classic surgical methods of shunting were inappropriate.     

Emergency room thoracotomy for acute traumatic cardiac tamponade caused by a blunt cardiac injury: A case report

IntroductionTraumatic blunt cardiac injuries have a high mortality rate, and prompt diagnosis and treatment can be lifesaving in cardiac tamponade.Presentation of caseA 62-year-old man was transferred to the emergency department after a motor vehicle accident. He was hemodynamically unstable. A focused assessment with sonography in trauma (FAST) showed pericardial fluid with right ventricular collapse consistent with cardiac tamponade in the subxiphoid view. He collapsed despite a subxiphoid pericardiotomy. Owing to the ongoing hemodynamic instability, we performed a left anterolateral thoracotomy. Direct incision of the pericardium showed blood and clots within the pericardial space, indicating hemopericardium. The heart stroke and hemodynamic status recovered on removing the clot.DiscussionAlthough the physical findings of cardiac tamponade are not always apparent in life-threatening acute cardiac tamponade after blunt trauma, FAST is a reliable tool for diagnosing and following cardiac tamponade. A median sternotomy is a standard approach for evaluating cardiac injury in hemodynamically stable patients with or without cardiopulmonary bypass. However, a left anterior thoracotomy was the fastest, simplest life-saving procedure considering the need for open-chest cardiac massage given our patient’s life-threatening condition.ConclusionA prompt diagnosis using FAST and treatment can be lifesaving in traumatic acute cardiac tamponade. A pericardiotomy via a thoracotomy is mandatory for lifesaving cardiac decompression in acute traumatic cardiac tamponade in cases of ineffective drainage due to clot formation within the pericardial space.     

Late partial tamponade of the right atrium. A case report

An unusual case of late partial tamponade of the right atrium is reported in a patient 35 days after aortic valve replacement. Chest x-rays, echocardiograms and ECG were not helpful. The diagnosis was made by emergency bedside right heart catheterization which showed a 7 cm H2O gradient between the junction of the superior vena cava and right atrium and also a 12 cm H2O pressure difference between the femoral vein and the right atrium with a normal capillary wedge pressure. Re-thoracotomy with evacuation of blood clots and control of bleeding points improved the hemodynamics dramatically. However the patient succumbed 3 weeks later due to irreversible brain damage. This is thought to be the first report of a late partial right atrial tamponade in the English medical literature.     

Delayed cardiac tamponade after the Nuss procedure for pectus excavatum: a case report and simple management

A 22-year-old man presented at our emergency department with clinical signs of cardiac tamponade that required emergency surgery. We treated this patient by using emergency echocardiographically guided pericardiocentesis with insertion of a central venous catheter for drainage without removal of the steel bar. The causes of his pericardial effusion appeared to have been displacement of the bar from a pectus excavatum repair 6 months previously and his ingestion of ginseng extract. This case illustrates a possible cause of cardiac tamponade after the Nuss procedure and a simple way to manage it.     

Ruptured aortic arch aneurysm with hemorrhagic cardiac tamponade: report of a case

A 67-year-old female was sent into our hospital for ruptured thoracic aneurysm with hemorrhagic cardiac tamponade. Computed tomography (CT) showed pericardial effusion and ruptured aortic arch aneurysm. We performed urgent graft replacement of the aortic arch using selective cerebral perfusion under mild hypothermia. Postoperative course was uneventful.     

A case of fatal cardiac tamponade during hemodialysis

A 27-year-old Hispanic man with a history of hypertension and end-stage renal disease for 4 years became unresponsive, apneic, and pulseless during hemodialysis. During his 4 year period on dialysis, vascular access had become increasingly difficult and ultimately a transhepatic catheter had been placed 9 months prior to this event. Resuscitation was unsuccessful. At autopsy, death was determined to be due to cardiac tamponade secondary to perforation of the right atrium by the transhepatic catheter. Cardiac tamponade is a rare cause of sudden death during hemodialysis with a long-standing catheter.