Pericardial tamponade caused by massive fluid resuscitation in a patient with pericardial effusion and end-stage renal disease -A case report-

Abstract

Pericardial tamponade can lead to significant hemodynamic derangement including cardiac arrest. We experienced a case of pericardial tamponade in a patient with end-stage renal disease. Hemodynamic changes occurred by unexpectedly aggravated pericardial effusion during surgery for iatrogenic hemothorax. We quickly administered a large amount of fluids and blood products for massive bleeding and fluid deficit due to hemothorax. Pericardial effusion was worsened by massive fluid resuscitation, and thereby resulted in pericardial tamponade. Hemodynamic parameters improved just after pericardiocentesis, and the patient was transferred to the intensive care unit.

Hemorrhagic Pericardial Effusion as the Presenting Symptom of Newly Diagnosed Rheumatoid Arthritis

“…with large pericardial effusions particularly dangerous as the fluid accumulation is quicker and more likely to lead to pericardial tamponade [10]. Paradoxically, once the diagnosis is made, RA-induced pericardial effusions respond well to treatment with pericardiocentesis followed either by NSAID or colchicine as required.…”

“…Research literature indicates that indolent accumulation of fluid usually takes more volume in order to cause tamponade than in an acute accumulation. This makes new acute flare-ups of RA with large pericardial effusions particularly dangerous as the fluid accumulation is quicker and more likely to lead to pericardial tamponade [ 10 ]. Paradoxically, once the diagnosis is made, RA-induced pericardial effusions respond well to treatment with pericardiocentesis followed either by NSAID or colchicine as required.…”

Cardiac Tamponade-Associated Dense Deposit Disease: A Case Report and Review of the Literature

“…Acute cardiac tamponade is a life-threatening condition, caused by pressure on the heart from fluid in the pericardial space that causes a severe decrease in ventricles diastolic filling. Thus, it requires a preemptive diagnosis and treatment [ 11 , 13 ]. The causes of pericardial effusion inducing pericardial tamponade are heart surgery, trauma, chest radiation, tumor, chest radiation, hypothyroidism, ESRD, invasive cardiac intervention, autoimmune disease, and acute inflammatory pericarditis [ 14 ].…”

“…Pericardial effusion and tamponade are extremely rare but serious complications of nephrotic syndrome [ 10 ]. When pericardial effusion generates pericardial tamponade, the patient usually develops dyspnea, tachycardia, jugular venous distension, and pulsus paradoxus, and these symptoms lead to hypotension and shock [ 11 ].…”