The Canadian journal of cardiology
-
Pericardiocentesis for therapeutic drainage of pericardial fluid may be associated with a variety of complications, including laceration of the right ventricle or coronary artery, arrhythmias, viscus perforation, hypotension, pneumothorax, adult respiratory distress syndrome and death. Hemodynamic derangements such as acute left ventricular failure, pulmonary edema and cardiogenic shock are infrequent and, hence, less well recognized. The present report describes a patient with pericardial effusion and tamponade who developed cardiogenic shock requiring inotropic support shortly following uncomplicated ultrasound-guided pericardial drainage.
-
The case of a patient with pheochromocytoma who presented with an unusual pattern of left ventricular dysfunction not previously described is reported. Although a triad of headaches, sweating attacks and palpitations is generally recognized as the classic mode of presentation of this pathology, this patient first presented with shock and pulmonary edema. Moreover, both echocardiography and angiography showed severe basal and mid-ventricular left ventricular dysfunction but preserved apical contractility. This hitherto unidentified finding was interpreted as being due to an afterload mismatch, rather than to an intrinsic myocardial injury, as is usually reported in such cases.