Open AccessHemorrhagic pericardial tamponade in a peritoneal dialysis patient
Author(s) -
Yuan Hwa Chou,
Ting Lin,
Ann Charis Tan,
Fan Yu Chen,
Wen Chung Yu,
Chih Ching Lin
Publication year - 2021
Publication title -
journal of the chinese medical association
Language(s) - Uncategorized
Resource type - Journals
eISSN - 1728-7731
pISSN - 1726-4901
DOI - 10.1097/jcma.0000000000000525
Subject(s) - medicine , pericardial effusion , pericarditis , peritoneal dialysis , cardiac tamponade , tamponade , pericardial fluid , surgery , pericardial window , complication , dialysis , cardiology
Uremic pericarditis and pericardial effusion are possible complications among patients with end-stage renal disease. The accumulation of toxic metabolites may contribute to the pathogenesis of uremic pericarditis. Bleeding diathesis in peritoneal dialysis patients raises the risk of hemorrhagic pericardial tamponade, which is a fatal complication of peritoneal dialysis. We report a case of hemorrhagic pericardial tamponade who was nonadherent to peritoneal dialysis with initial presentation of hypotension and syncope. Transthoracic echocardiogram revealed septated, fibrinoid pericardial effusion and right ventricular diastolic compression. A massive bloody pericardial effusion was drained when he underwent the pericardial window procedure. There was a significant improvement both in his clinical condition and in the echocardiogram images after the procedure. Hemorrhagic pericardial tamponade occurs in uremic patients but is rarely seen in those undergoing peritoneal dialysis. Early diagnosis, immediate surgical drainage, and regular follow-up with echocardiography are crucial to achieve better prognoses in future similar clinical scenarios.