Pericardium: The Forgotten Space During Acute Myocardial Infarction
Autor: | Georgios Lygouris, Mohammad Nour Zabad, Sandeep Dayanand, Christian Witzke, Akanksha Agrawal |
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Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
Time Factors 030204 cardiovascular system & hematology Transesophageal echocardiogram Chest pain Pericardial effusion Diagnosis Differential 03 medical and health sciences Pericarditis Electrocardiography 0302 clinical medicine Percutaneous Coronary Intervention Cardiac tamponade Internal medicine medicine Pericardium Humans cardiovascular diseases 030216 legal & forensic medicine Myocardial infarction Aged Ultrasonography medicine.diagnostic_test business.industry Middle Aged medicine.disease Cardiac Tamponade medicine.anatomical_structure Emergency Medicine Cardiology ST Elevation Myocardial Infarction Female Tamponade medicine.symptom business Tomography X-Ray Computed |
Zdroj: | The Journal of emergency medicine. 55(4) |
ISSN: | 0736-4679 |
Popis: | Background Acute pericardial pathologies, such as pericardial effusion, pericarditis, and cardiac tamponade, have been reported rarely in patients presenting as ST-elevation myocardial infarction (STEMI). We present a series of 3 patients with STEMI, where an undiagnosed pericardial effusion led to pericardial tamponade and subsequent cardiocirculatory collapse. Case Reports This is a case series of 3 patients, all women, aged 72, 64, and 54 years who presented to the emergency department with chest pain or syncope and were found to have STEMI with hemodynamic instability. They were taken to the catheterization laboratory for urgent coronary revascularization requiring mechanical circulatory support (intra-aortic balloon pump or impella). During catheterization, all 3 patients were diagnosed with large pericardial effusion using hemodynamic parameters and bedside transesophageal echocardiogram. Commonly ignored, pericardial tamponade and acute large pericardial effusion can be the cause of cardiocirculatory collapse. Two of the 3 patients survived with aggressive interventions requiring pericardial drains, long-term mechanical circulatory support, and effective postoperative rehabilitation. Why Should an Emergency Physician Be Aware of This? It is important for treating clinicians, including emergency physicians, intensivist, and cardiologist, to consider the differential of a cardiac tamponade due to a pericardial effusion as a potential cause for hypotension in patients with an acute STEMI. |
Databáze: | OpenAIRE |
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