Dataset Information

Hemorrhagic cardiac tamponade complicated by acute type A aortic dissection: A case report with critical care ultrasound findings.

ABSTRACT:

Rationale

Acute type A aortic dissection (AAAD) is a potentially fatal clinical crisis. Hemorrhagic cardiac tamponade due to the rupture of an ascending aortic root dissection is extremely dangerous and often lacks timely clinical evidence. We report sudden death in a patient diagnosed with AAAD and in whom critical care ultrasound highly indicated hemorrhagic cardiac tamponade.

Presenting concerns

A 75-year-old man was admitted to our emergency department with a complaint of chest pain for 8 hours. Computed tomography angiography findings indicated AAAD with a wide range of lesions. During the preoperative preparation process, he suddenly lost consciousness with a pulseless femoral artery.Diagnoses: Cardiopulmonary resuscitation was initiated and critical care ultrasound revealed hemorrhagic cardiac tamponade, strongly indicating the rupture of an ascending aortic root dissection.

Interventions

However, family members refused further surgical interventions.

Outcomes

The etiology could not be reversed and the patient died.

Lessons

Critical care ultrasound is an important skill that intensivists should master for fast screening of life-threatening complications in patients with AAAD.

SUBMITTER: Guo R

PROVIDER: S-EPMC5728849 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Publications

Hemorrhagic cardiac tamponade complicated by acute type A aortic dissection: A case report with critical care ultrasound findings.

Guo Rui R Feng Yan-Mei YM Wan Dong D

Medicine 20171201 49

<h4>Rationale</h4>Acute type A aortic dissection (AAAD) is a potentially fatal clinical crisis. Hemorrhagic cardiac tamponade due to the rupture of an ascending aortic root dissection is extremely dangerous and often lacks timely clinical evidence. We report sudden death in a patient diagnosed with AAAD and in whom critical care ultrasound highly indicated hemorrhagic cardiac tamponade.<h4>Presenting concerns</h4>A 75-year-old man was admitted to our emergency department with a complaint of ches ...[more]

PMID: 29245234

Similar Datasets

Project description:Introduction and importancePericarditis is a common illness that can appear in a variety of clinical settings and has numerous causes. In developing nations where tuberculosis is still a serious public health issue, more than 50% of cases of pericarditis are related to tuberculosis.Case presentationThere was no history of TB, alcoholism, IV drug abuse, immunosuppressant, or corticosteroid use. On examination, she had a fever, tachycardia, pulsus paradoxus of 10 mmHg, hypotension, tachypnea, and a distended jugular vein. On auscultation, her heartbeats were muffled, and accompanied by a pericardial rub. Laboratory investigation showed low hematocrit and a high WBC count with lymphocyte predominance. ESR and CRP levels were elevated. Her chest X-ray revealed an enlargement of the cardiac silhouette. The ECG showed low voltage complexes. Echocardiography showed circumferential 30 mm × 25 mm pericardial effusion with fibrin strands in the visceral pericardium. An emergency pericardiocentesis was performed under the guidance of transthoracic echocardiography using sub-xiphoidal standards. Microbiologic analysis of the pericardial fluid confirmed tuberculosis. After successful pericardiocenthesis, the patient's condition improved massively. After three days of pericardiocentasis drainage, TB treatment was started and she was discharged for outpatient flow up.Clinical discussionTuberculous pericarditis is a serious tuberculosis (TB) complication that can be difficult to diagnose and often goes undetected, leading to late complications such as constrictive pericarditis and cardiac tamponade, which lead to increased mortality. This current case illustrates a young female patient presenting with isolated TB pericarditis complicated by cardiac tamponade. She had massive improvement following pericardiocentesis and anti-TB treatment.ConclusionIn Africa, tuberculous pericarditis should be considered as a differential diagnosis in any patient presenting with moderate to massive pericardial effusion. A high index of suspicion is required for the diagnosis of extrapulmonary TB pericarditis, especially in patients without known risk factors.

Dataset Information

Hemorrhagic cardiac tamponade complicated by acute type A aortic dissection: A case report with critical care ultrasound findings.

Rationale

Presenting concerns

Interventions

Outcomes

Lessons

Publications

Hemorrhagic cardiac tamponade complicated by acute type A aortic dissection: A case report with critical care ultrasound findings.

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