Fatal Cardiac Tamponade: The Lethal Progression of Acute-on-Chronic Pericardial Effusion

Cardiac tamponade is a life-threatening occurrence with an incidence rate of about two out of 1,000 people. It is caused by the rapid accumulation of fluid in the pericardial sac. This can lead to the physical examination findings of tachycardia, hypotension, and elevated jugular venous pressure. Patients with chronic pericardial effusion are at increased risk for cardiac tamponade. We present a case of a patient with chronic, recurrent, malignant pericardial effusion that rapidly evolved to cardiac tamponade several hours from hospital presentation. We attempt to highlight the importance of close monitoring of patients who have recurrent chronic pericardial effusion in hopes of decreasing the number of patients who develop cardiac tamponade physiology.