Cardiac tamponade following post-pericardiotomy syndrome

Area of Science:

• Cardiovascular Surgery
• Trauma Surgery
• Emergency Medicine

Background:

• Subxyphoid pericardial window (SPW) is a common procedure for penetrating cardiac injury (PCI).
• Post-pericardiotomy syndrome (PPS) with cardiac tamponade is a known complication, typically occurring earlier after cardiac surgery or transdiaphragmatic pericardial windows.

Purpose of the Study:

• To report the first case of delayed post-pericardiotomy syndrome (PPS) with acute cardiac tamponade following a diagnostic subxyphoid pericardial window (SPW) for penetrating cardiac injury (PCI).

Main Methods:

• Case report of a patient who underwent a diagnostic subxyphoid pericardial window (SPW) for penetrating cardiac injury (PCI).
• Monitoring and management of the patient who subsequently developed symptoms consistent with post-pericardiotomy syndrome (PPS) with cardiac tamponade weeks after the initial procedure.

Main Results:

• The patient developed acute cardiac tamponade due to post-pericardiotomy syndrome (PPS) several weeks after a diagnostic subxyphoid pericardial window (SPW) for penetrating cardiac injury (PCI).
• This represents the first documented case of PPS with acute tamponade occurring at this delayed interval after a diagnostic SPW.

Conclusions:

• Delayed post-pericardiotomy syndrome (PPS) with acute cardiac tamponade can occur weeks after a diagnostic subxyphoid pericardial window (SPW) for penetrating cardiac injury (PCI).
• Clinicians should maintain a high index of suspicion for PPS even weeks after a diagnostic SPW in patients with penetrating cardiac injury (PCI).