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acute pericardial effusion after PCI

added by Emmel

acute pericardial effusion after PCI
Comments
Posted By: ohtusabes (907 days ago)

Amazing case! Thanks for sharing Jörg

Posted By: Emmel (907 days ago)

Hello Pablo!

That case was very interesting. It was a
PCI-related complication (the patient was in cardiac catheter lab 1
hour before when haemodynamic instability started)
I tried to tap
for aspiration (echo-guided puncture) the pericardial effusion, but
there was no location where I could reach the pericardial effusion
without possibility of injury the liever (the patient was highly
loaded with antiaggregatorical drugs like prasugrel,
acetylsalicyl-acid and tirofiban and anticoagulation (UFH, aPTT >
60sec).
So I didn´t do the tap and colleagues of cardiac
surgery took the pressure of the heart by cardiac operation with
implantation of two pericardial tubes. They foundnNo perforation of
ventricle, no dissection of coronary arteries.
After that the
patient survived and was dismissed from icu after 7 days.
/>Best wishes,

Jörg.

Posted By: ohtusabes (907 days ago)

Hello Jorg:

Very nice subcostal view. Large effusion and
cardiac tamponade.

What happens?

PCI related
complication? pericarditis episthenocardica?


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Emmel

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Added: 12-09-2011
Runtime: 0m 6s
Views: 7597
Comments: 3

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Description

about 45y old man with ST-elevated myocardial infarction. He was admitted to our hospital in cardiogenic shock after defibrillation and resusciation. the cardiac catheter showed a severe coronary disease. After PCI of 2 coronary arteries he was admitted to our ICU. It emerged a rapid hemodynamic instability. the transthoracic echocardiography showed an acute pericardial effusion


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