Rescuing the heart from tamponade with emergent ultrasound-guided pericardiocentesis: A case report

Cardiac tamponade following blunt and penetrating chest trauma is a life-threatening condition, and early recognition clinically and with the cardiac component in the Focused Assessment with Sonography in Trauma (cFAST) is paramount. Performing an emergent pericardiocentesis is key in achieving hemodynamic stability.

A male victim of a motor-vehicle accident presented with distended neck veins, muffled heart sounds, and hemodynamic instability. The cFAST confirmed cardiac tamponade, and emergency ultrasound-guided subxiphoid-pericardiocentesis was performed.

Classical findings in cardiac tamponade (Beck's triad) were present in our multiple-injured patient. Cardiac tamponade is a sequel of hemodynamic instability due to extrinsic cardiac compression from pericardial fluid. Up to 200 millitres can be fatal; about 180 millitres was aspirated from the index patient who achieved hemodynamic stability without surgical intervention.

We highlighted the importance of early diagnosis and ultrasound-guided pericardiocentesis in acute cardiac tamponade.