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Síndrome de descompresión pericárdica tras pericardiocentesis de gran volumen en esclerosis sistémica

Ahmed Al Mubaid¹, Martha Plasencia¹, Amir Abusharif¹

¹Franciscan Hospital, Midwestern University, Olympia Field, Illinois, USA.

JACC. Case reports

|February 24, 2026

Resumen

El síndrome de descompresión pericárdica (SDP) es una complicación rara después de la pericardiocentesis, que causa un deterioro hemodinámico. El drenaje rápido de líquidos en pacientes con derrames crónicos y cardiopatías puede desencadenar el SDP, lo que requiere un diagnóstico cuidadoso.

Área de la Ciencia:

Cardiología
Medicina de Cuidados Críticos

Sus antecedentes:

El síndrome de descompresión pericárdica (SDP) es una complicación rara de la pericardiocentesis.
Se presenta como un deterioro hemodinámico paradójico después del alivio del derrame pericárdico.

Objetivo del estudio:

Destacar la naturaleza subestimada del SDP.
Enfatizar la importancia de considerar el SDP en el deterioro post-pericardiocentesis.

Principales métodos:

Informe de caso de una mujer de 32 años con esclerosis sistémica y derrame pericárdico grande.
Pericardiocentesis rápida de gran volumen seguida de insuficiencia respiratoria aguda y paro cardíaco.
Diagnóstico de SDP confirmado por ecocardiografía que muestra disfunción sistólica del ventrículo izquierdo.

Principales resultados:

El paciente desarrolló SDP horas después de la pericardiocentesis.
El diagnóstico erróneo de taponamiento recurrente provocó complicaciones, incluida la perforación del ventrículo derecho.
Se logró la recuperación completa de la función ventricular con cuidados de apoyo.

Conclusiones:

El SDP puede ser precipitado por un drenaje rápido en pacientes con derrames crónicos y enfermedad miocárdica subyacente.
Considerar el SDP en el deterioro post-pericardiocentesis para evitar diagnósticos erróneos y complicaciones.
Un drenaje pericárdico más lento o escalonado puede mitigar el riesgo de SDP.

Palabras clave:

síndrome de descompresión pericárdica pericardiocentesis cardiomiopatía esclerodérmica esclerosis sistémica

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