Pericardial decompression syndrome (PDS) is a rare and serious complication that follows often-initially-uncomplicated pericardial drainage in patients with pericardial effusion and tamponade physiology. The pathophysiology of PDS is not yet completely understood, although several mechanisms have been postulated. In this report, we present a case of PDS in a 70-year-old male with end-stage renal disease (ESRD) after he underwent a surgical pericardial window for drainage of a moderate pericardial effusion with tamponade physiology. This case provides further evidence that rapid pericardial decompression, notably with pericardiotomy, can lead to acute life-threatening low cardiac output heart failure, particularly in patients with underlying cardiac risk factors. Early recognition, diagnosis, and supportive treatment in the ICU are crucial for improving survival rates in these patients.
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http://dx.doi.org/10.7759/cureus.16631 | DOI Listing |
Prehosp Emerg Care
December 2024
Department of Emergency Medicine, North Memorial Health Level I Trauma Center, Minneapolis, Minnesota.
Acutely injured trauma patients may develop shock from several potential mechanisms, including hypovolemic shock from hemorrhage, neurogenic shock from traumatic brain injury (TBI) or spinal cord injury, obstructive shock from tension pneumothorax or pericardial tamponade, or a mix of several of these mechanisms. Regardless of the cause, restoration of adequate perfusion is of critical importance to reduce the morbidity and mortality of trauma patients with shock. Multiple interventions including hemorrhage control, volume resuscitation with intravenous fluids or blood products, and pleural decompression procedures are used to address some of these issues and are discussed elsewhere in the trauma compendium.
View Article and Find Full Text PDFEur Heart J Case Rep
December 2024
Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, 210008 Nanjing, China.
Background: Patients with recurrent massive pericardial effusion are at risk of recurrent cardiac tamponade. The current standard of care includes repeat pericardiocentesis or pericardial window when recurrent effusions cause haemodynamic compromise. Here, we report a case of a patient in whom an infusion port was used for drainage of recurrent pericardial effusion.
View Article and Find Full Text PDFMedicina (Kaunas)
October 2024
Department of Anaesthesia and Intensive Care, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania.
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.
View Article and Find Full Text PDFInt J Emerg Med
October 2024
Department of Cardiac Surgery, Fuwai Hospital, Beijing, China.
CASE (Phila)
August 2024
Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas.
• PDS is a potential complication of pericardiocentesis. • Apply caution when considering a pericardiocentesis for effusions of unknown chronicity. • Serial assessment with bedside TTE can guide slow pericardiocentesis to avoid PDS.
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