Cardiac Tamponade due to Pneumopericardium

Abstract

We describe a newborn with acute respiratory distress syndrome, subjected to mechanical ventilatory assistance with high level of peak inspiratory pressure (PIP) and positive end expiratory pressure (PEEP), who developed cardiac tamponade due to pneumopericardium. Tension pneumopericardium produces the same physiological derangement as cardiac tamponade secondary to accumulated blood or other fluids. This life-threatening complication demands immediate diagnosis and treatment.

Spontaneous pneumomediastinum and subcutaneous emphysema in asthma exacerbation: The Macklin effect

“…[17][18][19][20][21][22][23][24][25][26] It can also be associated with pneumopericardium producing tamponade pneumoperitoneum, and with pneumorrhachis. [27][28][29][30][31] However, it is usually self-limited, and rarely leads to serious complications. More often, the associated condition underlying SPM may be the cause of significant and potentially life-threatening complications.…”

Spontaneous pneumopericardium in a term newborn: a case report

“…From there, the air enters the pericardial space at the site of reflection of the parietal pericardium onto the visceral pericardium thereby producing the pneumopericardium. 16 Moreover, the decreased number and size of Kohn pores in newborns leads to an inability for air to equilibrate between aerated and nonaerated alveoli. 8 The mechanism of spontaneous pneumopericardium in term infants with no mechanical ventilation or lung pathology is unclear.…”

Tension Pneumohydropericardium: A Heart Under Stress

“…The probable cause of pneumohydropericardium after pericardiocentesis is leakage of the drainage system or another possible mechanism for the development of pneumopericardium can be a direct connection between the lung tissue and the pericardial sac due to erroneous placement of the needle. The pneumohydropericardium after pericardiocentesis is rarely reported; however, this may be lethal due rapid accumulation of the air and fluid . Most cases can be managed nonsurgically with percutaneous placement of an angio‐catheter in the pericardial space, and a chest tube if a communication exists between the pericardial and the pleural cavities.…”

“…The pneumohydropericardium after pericardiocentesis is rarely reported; how-ever, this may be lethal due rapid accumulation of the air and fluid. 3,4 Most cases can be managed nonsurgically with percutaneous placement of an angio-catheter in the pericardial space, and a chest tube if a communication exists between the pericardial and the pleural cavities. The pericardiectomy may be necessary in recurrent pneumohydropericardium or after failure of the percutaneous drainage.…”