alexa Bedside Echocardiographically Guided Pericardiocentesis for Cardiac Tamponade after Coronary Artery Injury Secondary to Percutaneous Coronary Intervention: A Case Report and Descriptive Technique
ISSN: 2165-7920

Journal of Clinical Case Reports
Open Access

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Case Report

Bedside Echocardiographically Guided Pericardiocentesis for Cardiac Tamponade after Coronary Artery Injury Secondary to Percutaneous Coronary Intervention: A Case Report and Descriptive Technique

Graham Brant-Zawadzki*, Marina Trilesskaya and Arun Nagdev
Alameda Health System-Highland General Hospital, USA
*Corresponding Author : Graham Brant-Zawadzki
Alameda Health System-Highland General Hospital, USA
Tel: (510) 437-4564
Fax: (510) 437-8322
E-mail: [email protected]
Received: January 29, 2016; Accepted: March 09, 2016; Published: March 13, 2016
Citation: Brant-Zawadzki G, Trilesskaya M, Nagdev A (2016) Bedside Echocardiographically Guided Pericardiocentesis for Cardiac Tamponade after Coronary Artery Injury Secondary to Percutaneous Coronary Intervention: A Case Report and Descriptive Technique. J Clin Case Rep 6:740. doi:10.4172/2165-7920.1000740
Copyright: © 2016 Brant-Zawadzki G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Given over 2.64 million total percutaneous coronary interventions performed in the United States, and that acute cardiac tamponade is one of the most common complications of such percutaneous coronary interventions, clinicians should be familiar with diagnosing impending pericardial tamponade, and a simple and safe bedside technique for drainage. We describe a technique for echocardiographically guided rescue pericardiocentesis in the setting of acute tamponade to demonstrate the efficacy and safety of this technique for pericardial drainage with reduced complication risk as compared to a landmark-based approach. A case of a 52-year-old male was brought to the Emergency Department after a witnessed cardiac arrest. He underwent cardiac catheterization and percutaneous coronary stent implantation. Thirty minutes after stenting, the patient developed signs of cardiac tamponade, and point-of-care echocardiogram confirmed a pericardial effusion. An in-plane ultrasound-guided pericardiocentesis was successfully performed by the junior house-staff under direct attending supervision. Serial echocardiograms demonstrated preserved left ventricular systolic function without new effusion. The patient remained hemodynamically stable for 48 hrs following the procedure at which time the pericardial catheter was removed. Ultrasound image guided pericardiocentesis is a rapid and safe technique for pericardial drainage with reduced complication risk as compared to a landmark-based approach.

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