Cardiac tamponade related to a coronary injury by a pericardial calcification: an unusual complication
| Autor: | Anne Cypierre, Francis Pesteil, François Parraf, Claude Cassat, Lionel Ursulet, Bruno François, Rémy Bellier, Philippe Vignon, Claire Eveno |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Case Report Hemopericardium Coronary artery Pericardial effusion Pericardial Effusion Internal medicine Cardiac tamponade medicine Pericardium Humans Coronary artery aneurysm Aged 80 and over business.industry Tamponade Hémopéricardium Calcinosis medicine.disease Surgery Cardiac surgery Cardiac Tamponade medicine.anatomical_structure lcsh:RC666-701 Echocardiography Cardiology Chronic péricarditis Cardiology and Cardiovascular Medicine Complication business Cardiomyopathies |
| Zdroj: | BMC Cardiovascular Disorders BMC Cardiovascular Disorders, Vol 12, Iss 1, p 28 (2012) |
| ISSN: | 1471-2261 |
| Popis: | Background Cardiac tamponade is a rare but severe complication of pericardial effusion with a poor prognosis. Prompt diagnosis using transthoracic echocardiography allows guiding initial therapeutic management. Although etiologies are numerous, cardiac tamponade is more often due to a hemopericardium. Rarely, a coronary injury may result in such a hemopericardium with cardiac tamponade. Coronary artery aneurysm are the main etiologies but blunt, open chest trauma or complication of endovascular procedures have also been described. Case presentation A 83-year-old hypertensive man presented for dizziness and hypotension. The patient had oliguria and mottled skin. Transthoracic echocardiography disclosed a circumferential pericardial effusion with a compressed right atrium, confirmed by contrast-enhanced thoracic CT scan. A pig-tail catheter allowed to withdraw 500 mL of blood, resulting in a transient improvement of hemodynamics. Rapidly, recurrent hypotension prompted a reoperation. An active bleeding was identified at the level of the retroventricular coronary artery. The pericardium was thickened with several "sharping" calcified plaques in the vicinity of the bleeding areas. On day 2, vasopressors were stopped and the patient was successfully extubated. Final diagnosis was a spontaneous cardiac tamponade secondary to a coronary artery injury attributed to a "sharping"calcified pericardial plaque. Conclusion Cardiac tamponade secondary to the development of a hemopericardium may develop as the result of a myocardial and coronary artery injury induced by a calcified pericardial plaque. |
| Databáze: | OpenAIRE |
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