JACC. Case reports · 2025
Paradoxical Hemodynamics in Pericardial Decompression Syndrome: Cardiogenic Shock and Recovery With Mechanical Circulatory Support.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
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Bahuva Ronak, Singh Arminder, Chapa-Rodriguez Alejandro, Hayagreev Vibha, Fichadiya Hardik, Patel Amar, Haseeb Riaz Abdul, Sarwar Hafiz, Younus Usman, Bahekar Amol
Аннотация
BACKGROUND: Pericardial decompression syndrome is a rare but potentially fatal complication of pericardiocentesis or surgical drainage, causing paradoxical hemodynamic collapse despite technically successful fluid evacuation.
CASE SUMMARY: A 59-year-old woman with malignant pericardial effusion underwent pericardial window surgery. Four hours later, she developed refractory shock and severe left ventricular dysfunction with a Takotsubo pattern, despite nonobstructive coronary arteries. A percutaneous left ventricular assist device provided hemodynamic support. Her left ventricular function gradually recovered.
DISCUSSION: Pericardial decompression syndrome may involve hemodynamic, ischemia, and autonomic pathophysiology. Mechanical circulatory support can bridge recovery in pericardial decompression syndrome complicated by stress cardiomyopathy.
TAKE-HOME MESSAGES: Pericardial fluid drainage can paradoxically lead to cardiogenic shock given multifactorial hemodynamic and neurohormonal responses; clinicians should maintain high vigilance for hemodynamic deterioration even after technically successful drainage. Mechanical circulatory support with a percutaneous left ventricular assist device can provide effective stabilization and myocardial recovery and can be lifesaving in nonischemic cardiogenic shock.
CASE SUMMARY: A 59-year-old woman with malignant pericardial effusion underwent pericardial window surgery. Four hours later, she developed refractory shock and severe left ventricular dysfunction with a Takotsubo pattern, despite nonobstructive coronary arteries. A percutaneous left ventricular assist device provided hemodynamic support. Her left ventricular function gradually recovered.
DISCUSSION: Pericardial decompression syndrome may involve hemodynamic, ischemia, and autonomic pathophysiology. Mechanical circulatory support can bridge recovery in pericardial decompression syndrome complicated by stress cardiomyopathy.
TAKE-HOME MESSAGES: Pericardial fluid drainage can paradoxically lead to cardiogenic shock given multifactorial hemodynamic and neurohormonal responses; clinicians should maintain high vigilance for hemodynamic deterioration even after technically successful drainage. Mechanical circulatory support with a percutaneous left ventricular assist device can provide effective stabilization and myocardial recovery and can be lifesaving in nonischemic cardiogenic shock.