J Korean Med Sci.  2016 Mar;31(3):470-472. 10.3346/jkms.2016.31.3.470.

Tension Pneumopericardium after Pericardiocentesis

• Lee J
• Kang BS
• Kim C
• Choi HJ

• KMID: 2363512
• DOI: http://doi.org/10.3346/jkms.2016.31.3.470

Abstract

Pneumopericardium is defined as the presence of air inside the pericardial space. Usually, it is reported as a complication of blunt or penetrating chest trauma, but rare iatrogenic and spontaneous cases have been reported. Pneumopericardium is relatively stable if it does not generate a tension effect on the heart. However, it may progress to tension pneumopericardium, which requires immediate pericardial aspiration. We report a case of iatrogenic pneumopericardium occurred in a 70-year-old man who presented dyspnea at emergency department. The patient underwent pericardiocentesis for cardiac tamponade due to large pericardial effusion, and iatrogenic tension pneumopericardium occurred due to misuse of the drainage device. After evacuating the pericardial air through the previously implanted catheter, the patient became stable. We report this case to increase the awareness of this fatal condition and to help increase the use of precautions against the development of this condition during emergency procedures.

Keyword

Pericardiocentesis; Pneumopericardium; Iatrogenic Disease; Complication

MeSH Terms

Aged
Cardiac Tamponade/etiology
Drainage
Dyspnea/diagnosis
Emergency Medical Services
Heart Ventricles/physiopathology
Humans
Male
Medical Errors
Pericardial Effusion/diagnostic imaging/*therapy
*Pericardiocentesis
Pneumopericardium/*diagnosis/therapy
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A contrast-enhanced computed tomography scan of the chest. (A) Axial view showed the air compressing the right ventricle (arrows) and tip of the catheter inside pericardium (arrow head). (B) Coronal view showed the air inside pericardial sac (arrows).

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