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Iatrogenic cardiac tamponade during pregnancy
1Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Summary
A pregnant patient successfully treated for preterm labor developed a pericardial effusion. A complication during pericardiocentesis led to cardiac tamponade and shock, requiring emergency pericardiotomy.
Area of Science:
- Cardiology
- Obstetrics
- Critical Care Medicine
Background:
- A 26-year-old primigravida presented with threatened preterm labor.
- Treatment with sulindac successfully suppressed preterm labor.
- A concurrent finding of pericardial effusion was noted.
Observation:
- The pericardial effusion showed evidence of right ventricular compression.
- Pericardiocentesis was performed to relieve the compression.
- The procedure was complicated by inadvertent left ventricular puncture.
Findings:
- Cardiac tamponade and hypovolemic shock ensued following the complication.
- An emergency pericardiotomy was urgently performed.
- The patient required immediate surgical intervention for rescue.
Implications:
- This case highlights a rare but serious complication of pericardiocentesis in pregnancy.
- It underscores the importance of careful technique and preparedness for emergent procedures.
- Management of cardiac emergencies in pregnant patients requires multidisciplinary collaboration.