%0 Case Reports
%T Cardiac tamponade complicating thoracentesis in a patient after left pneumonectomy: A case report.
%A Zheng M
%A Kang Y
%A Wang T
%A Wei J
%J Medicine (Baltimore)
%V 99
%N 15
%D Apr 2020
%M 32282740
%F 1.817
%R 10.1097/MD.0000000000019778
%X BACKGROUND: Therapeutic or diagnostic thoracentesis is widely used in different clinical settings. Cardiac injury, a rare complication, could lead to fatal consequences. We describe a case of cardiac tamponade complicating thoracentesis that was recognized and rescued in a timely manner.
METHODS: A 42-year-old woman underwent blind thoracentesis due to excessive left pleural effusion after left pneumonectomy surgery. She suddenly lost consciousness and was in a state of shock a few minutes after needle insertion and fluid drainage.
METHODS: Bedside transthoracic echocardiography revealed pericardial effusion at a depth of 20 mm, and cardiac tamponade complicating thoracentesis was diagnosed.
METHODS: After draining 250 mL of non-coagulated blood by pericardiocentesis under transthoracic echocardiography guidance, a tube was placed for continuous drainage over the subsequent 36 hours.
RESULTS: The patient's hemodynamic condition was stabilized hours after pericardiocentesis. The patient was discharged in good condition a few days later.
CONCLUSIONS: Imaging assessment and guidance in the process of thoracentesis was indispensable, especially in a patient with altered intra-thoracic anatomy. Cardiac damage, as a life-threatening complication, should be considered once hemodynamic instability occurs during the procedure.