Imaging manifestations of
cardiac tamponade include fattening of the walls of the right ventricle and/or atrium, straightening of the interventricular septum, a dilated inferior vena cava, and refux of intravenous contrast material into the inferior vena cava, azygos, and hepatic veins (Fig.
In patients with posttraumatic arrhythmia, clinicians primarily consider cardiac injuries such as myocardial contusion, cardiac failure, and
cardiac tamponade. However, various cardiac arrhythmias without BCI can also be seen due to the electrical disturbances that occur after trauma (1, 3).
Cardiac tamponade: Curr Opin Crit Care 2011; 17: 416-424.
New Delhi [India], Jan 5 ( ANI ):
Cardiac tamponade is a medical emergency in which blood or fluids fill the space between the sac that covers the heart and the heart muscle.
Symptoms of involvement include heart failure, pericardial pain, rhythm abnormalities,
cardiac tamponade, and even superior vena cava syndrome [8].
However, rare cases of pericarditis and
cardiac tamponade have been reported in adults and children [26, 27].
Altered hepatic metabolism resulting from coadministration with amiodarone and transient renal impairment synergistically resulted in supratherapeutic serum levels of rivaroxaban in our patient resulting in nontraumatic hemopericardium and eventual
cardiac tamponade.
While the initial clinical presentation was consistent with a viral prodrome leading to septic shock, the development of cardiogenic shock secondary to
cardiac tamponade has not been previously described.
If this condition worsens, the syndrome may result in
cardiac tamponade with subsequent constrictive pericarditis [6].
Subsequently, an echocardiogram was done to further delineate the effusion which revealed a large circumferential effusion with mild respiratory variation concerning for impending
cardiac tamponade (Figure 2).
Lowe, "Pneumopericardium resulting in
cardiac tamponade," Annals of Thoracic Surgery, vol.
A bedside, targeted neonatal echocardiogram showed good biventricular function, nondistended inferior vena cava, and no evidence of
cardiac tamponade. Because of increasing respiratory distress and increasing Fi[O.sub.2] to 70-100%, a needle aspiration of the right pneumothorax was performed under aseptic precautions, without analgesia using 23G butterfly needle attached to a syringe with a 3-way stopcock, at the right 2nd intercostal space just above the costal margin of the third rib at the midclavicular line.