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Open Access 12-12-2022 | Heart Beat

An ‘airy’ cardiac silhouette—pumping in the wrong direction

Auteurs: J. M. Santos, V. D. Neto, E. Correia, J. G. Pereira

Gepubliceerd in: Netherlands Heart Journal | Uitgave 1/2023

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A 44-year-old man with a past medical history of epilepsy was admitted to the hospital because of dyspnoea. Physical examination revealed hypotension (blood pressure: 88/60 mm Hg), tachycardia (heart rate: 115 bpm), polypnoea, jugular venous distention and muffled heart sounds. Blood analysis showed leucocytosis, neutrophilia and an elevated C‑reactive protein level (12.2 mg/dl). Electrocardiography indicated atrial fibrillation and low voltage on the frontal plane. A chest radiograph revealed an enlarged cardiac silhouette with mild pleural effusion (Fig. 1a). Bedside echocardiography confirmed the presence of severe pericardial effusion with signs of ventricular interdependence. Emergent pericardiocentesis was performed, after which the patient improved haemodynamically.
However, 24 h after the pericardiocentesis, the patient complained of worsening dyspnoea. A repeat chest radiograph showed a pneumopericardium (Fig. 1b), presumably caused by accidental entrapment of air via the pericardial drain during changing of the drainage bag. A conservative approach was decided, and the pneumopericardium resolved spontaneously within one week.

Conflict of interest

J.M. Santos, V.D. Neto, E. Correia and J.G. Pereira declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://​creativecommons.​org/​licenses/​by/​4.​0/​.
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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Metagegevens
Titel
An ‘airy’ cardiac silhouette—pumping in the wrong direction
Auteurs
J. M. Santos
V. D. Neto
E. Correia
J. G. Pereira
Publicatiedatum
12-12-2022
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 1/2023
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-022-01750-3

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