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Left ventricular wall hematoma and cardiac tamponade complicating percutaneous coronary intervention using IIb/IIIa

Carlos Van Mieghem1, Jo Dens, Marie-Christine Herregods

  • 1Department of Cardiology, University Hospital of Gasthuisberg, Herestraat 49, B-3000, Leuven, Belgium. cvanmieghem@hotmail.com

Journal of Interventional Cardiology
|November 8, 2003
PubMed

Insights

A rare case of cardiac tamponade and intramyocardial hematoma following percutaneous coronary intervention is presented. The antiplatelet effect of glycoprotein IIb/IIIa receptor antagonists is the likely cause of hemorrhage.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiovascular Research

Background:

  • Percutaneous coronary intervention (PCI) is a common procedure for treating coronary artery disease.
  • Complications, though rare, can occur during or after PCI.
  • Glycoprotein IIb/IIIa receptor antagonists are potent antiplatelet agents used to prevent thrombotic complications during PCI.

Observation:

  • A patient developed an intramyocardial hematoma and subsequent cardiac tamponade after a complicated PCI.
  • The clinical presentation included signs and symptoms consistent with acute hemodynamic compromise.

Findings:

  • The intramyocardial hematoma was diagnosed and managed conservatively.
  • The likely mechanism for the hemorrhage was the potent antiplatelet effect of glycoprotein IIb/IIIa receptor antagonists, leading to bleeding into the cardiac tissue.
  • Cardiac tamponade developed due to the accumulation of blood within the pericardial space.

Implications:

  • This case highlights a rare but serious complication of PCI associated with glycoprotein IIb/IIIa receptor antagonist use.
  • Careful patient selection and monitoring are crucial when using potent antiplatelet agents in complex PCI procedures.
  • Understanding the hemostatic risks associated with antiplatelet therapy is essential for managing cardiovascular emergencies.

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