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We present the case of a late presenting ST-elevation myocardial infarction with a coronary dissection. After primary percutaneous coronary intervention, the patient went on to develop pericardial effusion with tamponade. Despite only a small volume of fluid, we demonstrate how it can have significant clinical consequences in the diseased heart. We also highlight the value of being able to carry out bedside echocardiography in the acutely unwell post-myocardial infarction patient.

Lessons of the month 5: Cardiac tamponade after an acute myocardial infarction: the clinical diagnosis