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Persistent ST-segment elevation following pericardiocentesis: caution with thrombolytic therapy
H H Hsia1, N H Kander, M J Shea
1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.
Intensive Care Medicine
|January 1, 1988
Insights
Persistent ST-elevation after pericardiocentesis can indicate subepicardial injury from myocardial laceration, not infarction. This case highlights a rare complication following the procedure.
Area of Science:
- Cardiology
- Medical Case Reports
Background:
- Pericardiocentesis is a procedure to drain fluid from the pericardial sac.
- Persistent ST-elevation on electrocardiography (ECG) typically suggests myocardial infarction.
Observation:
- A case of persistent ST-elevation was observed post-pericardiocentesis.
- No evidence of transmural infarction or coronary vasospasm was found.
Findings:
- The electrocardiographic pattern indicated subepicardial injury.
- This injury was attributed to a small myocardial laceration caused by the pericardiocentesis needle.
Implications:
- This finding expands the differential diagnosis for ST-elevation post-pericardiocentesis.
- It underscores the importance of considering procedural complications in ECG interpretation.
Abstract:
We report a case of persistent electrocardiographic ST-elevation following pericardiocentesis despite lack of evidence for transmural infarction or vasospasm. The electrocardiographic pattern was felt to reflect subepicardial injury due to a small myocardial laceration. The implications of this finding are discussed.