Cardiac perforation and tamponade from a malpositioned subclavian dialysis catheter.

We report a case in which the tip of a malpositioned subclavian dialysis catheter perforated the right atrium and caused a hemopericardium and cardiac arrest. This complication must be immediately recognized and treated, probably by thoracotomy, to ensure survival. Needle aspiration of the pericardium will not remove clotted blood and is unlikely to be of value.