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Cardiac tamponade complicating thoracentesis in a patient after left pneumonectomy: A case report.

Abstract：

RATIONALE:Therapeutic or diagnostic thoracentesis is widely used in different clinical settings. Cardiac injury, a rare complication, could lead to fatal consequences. We describe a case of cardiac tamponade complicating thoracentesis that was recognized and rescued in a timely manner. PATIENT CONCERNS:A 42-year-old woman underwent blind thoracentesis due to excessive left pleural effusion after left pneumonectomy surgery. She suddenly lost consciousness and was in a state of shock a few minutes after needle insertion and fluid drainage. DIAGNOSIS:Bedside transthoracic echocardiography revealed pericardial effusion at a depth of 20 mm, and cardiac tamponade complicating thoracentesis was diagnosed. INTERVENTIONS:After draining 250 mL of non-coagulated blood by pericardiocentesis under transthoracic echocardiography guidance, a tube was placed for continuous drainage over the subsequent 36 hours. OUTCOMES:The patient's hemodynamic condition was stabilized hours after pericardiocentesis. The patient was discharged in good condition a few days later. LESSONS:Imaging assessment and guidance in the process of thoracentesis was indispensable, especially in a patient with altered intra-thoracic anatomy. Cardiac damage, as a life-threatening complication, should be considered once hemodynamic instability occurs during the procedure.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Zheng M,Kang Y,Wang T,Wei J

doi

10.1097/MD.0000000000019778

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

e19778

issue

15

eissn

0025-7974

issn

1536-5964

pii

00005792-202004100-00049

journal_volume

99

pub_type

杂志文章

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