Relapsing cardiac tamponade

Introduction: Cardiac tamponade is the decompen-sated phase of cardiac compression due to fluid accu-mulation and increased intrapericardial pressure. Eti-ological classification include: infectious percarditis, autoimmune ethyiology, post-myocardial infarction syndrome and neoplastic pericarditis.
Methods: We present the case of a 61-year-old patient without a known cardiovascular history who is hospi-talized in emergency for sudden two-day dyspnea and dizziness. On admission, the patient is conscious, pal-pable, effete, clinically objective with rhythmic heart rhythms, heart frequency 75 b/min, blood pressure 70/50 mm Hg and paradoxical pulse.The electrocardi-ogram shows a sinus rhythm with diffuse elevation in V2-V4 and DI, DII, aVF. The thoraco-abdominal com-puter tomography excludes a neoplastic pathology at this level. Echocardiography reveals an non-dilated left ventricle with normal and normal segmental systolic function (55% vol. FE), with massive pericardial fluid circumferentially disposed around the heart („swinging heart“ aspect).
Results: T he condition of the patient remained hae-modynamically stable after repeated evacuation of the pericardial fluid and initiation of corticoid treatment. A possible ethiology diagnosis was undergone: auto-immune by antibody dosing, endocrinological for an eventual thyroid pathology, a possible neoplastic or an infectious cause (viral, bacterial, tuberculous, parasito-logical).
Conclusions: Causes of pericardial effusions are often exclusion diagnoses, involving a clinical, imagistic, bi-ological, histopathological diagnostic algorithm. Often, the ethiology of massive pericardial effusion remains unknown.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
ESC search engine
CODE: 379
CME Credits: 10 (Romanian College of Physicians)