Cardiac Tamponade Secondary to Anterior Mediastinal Mass: A Cardiology-Centered Approach to Diagnosis and Intervention.

BACKGROUND

Anterior mediastinal masses can lead to life-threatening complications, including pericardial effusion and cardiac tamponade. These cases pose significant diagnostic and therapeutic challenges, particularly when mass effect increases procedural risk, necessitating multidisciplinary planning.

CASE SUMMARY: A 45-year-old man presented with progressive dyspnea and was found to have cardiac tamponade physiology due to a large pericardial effusion in the setting of an anterior mediastinal mass. Transthoracic echocardiography demonstrated tamponade features. Given the extensive anterior mass compression and high risk associated with general anesthesia and surgical intervention, a cardiology-led approach with apical pericardiocentesis was pursued.

DISCUSSION: This case highlights the complexity of managing pericardial disease in the presence of anterior mediastinal pathology. It emphasizes the importance of detailed echocardiographic assessment, individualized procedural planning, and close collaboration between cardiology and cardiothoracic teams.

TAKE-HOME MESSAGE: Echocardiography-guided apical pericardiocentesis is an effective strategy for managing tamponade with anterior mediastinal masses when surgical risks are high.