Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report
Background: Pneumopericardium is the presence of air within the pericardial cavity. We report a case of iatrogenic pneumopericardium following pericardiocentesis in a patient with primary cardiac angiosarcoma. Additionally, we provide a systematic review of pericardiocentesis-associated pneumoperica...
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2025-06-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| author | Andreas Merz Hong Ran Cheng-Ying Chiu Henryk Dreger Daniel Armando Morris Matthias Schneider-Reigbert |
| author_facet | Andreas Merz Hong Ran Cheng-Ying Chiu Henryk Dreger Daniel Armando Morris Matthias Schneider-Reigbert |
| author_sort | Andreas Merz |
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| description | Background: Pneumopericardium is the presence of air within the pericardial cavity. We report a case of iatrogenic pneumopericardium following pericardiocentesis in a patient with primary cardiac angiosarcoma. Additionally, we provide a systematic review of pericardiocentesis-associated pneumopericardium to offer a comprehensive overview and evaluate the role of echocardiography in its diagnosis. Methods: The PubMed database was searched from inception until January 2025 to perform a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate articles on iatrogenic pneumopericardium following pericardiocentesis published in the English language. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was used to appraise the included case reports. Results: Of the 108 search results obtained, after screening and a backward citation search, 37 articles were selected for inclusion in this review, accounting for a total of 37 patients. According to the JBI Critical Appraisal Checklist for Case Reports, 7 case reports were of high quality and 12 of low quality. The overall evidence of quality of the case reports was moderate, and 51.6% of patients developed hemodynamic compromise or showed signs of cardiac tamponade. The main underlying cause for the development of pneumopericardium was issues relating to the catheter drainage system; 64.9% of cases required decompressive therapy. Conclusions: Pneumopericardium can occur as a complication after pericardiocentesis and must therefore be considered in symptomatic patients. While detection by transthoracic echocardiography is difficult and relies on non-validated signs, chest X-ray and computed tomography can provide a definitive diagnosis. |
| format | Article |
| id | doaj-art-3a5226f2f75449c5a1782727425ea8b5 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-06-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-3a5226f2f75449c5a1782727425ea8b52025-08-20T03:58:29ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-06-0112724610.3390/jcdd12070246Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case ReportAndreas Merz0Hong Ran1Cheng-Ying Chiu2Henryk Dreger3Daniel Armando Morris4Matthias Schneider-Reigbert5Deutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, 13353 Berlin, GermanyDepartment of Echocardiography, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, ChinaDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, 13353 Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, 13353 Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, 13353 Berlin, GermanyDeutsches Herzzentrum der Charité, Department of Cardiology, Angiology and Intensive Care Medicine, 13353 Berlin, GermanyBackground: Pneumopericardium is the presence of air within the pericardial cavity. We report a case of iatrogenic pneumopericardium following pericardiocentesis in a patient with primary cardiac angiosarcoma. Additionally, we provide a systematic review of pericardiocentesis-associated pneumopericardium to offer a comprehensive overview and evaluate the role of echocardiography in its diagnosis. Methods: The PubMed database was searched from inception until January 2025 to perform a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to evaluate articles on iatrogenic pneumopericardium following pericardiocentesis published in the English language. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports was used to appraise the included case reports. Results: Of the 108 search results obtained, after screening and a backward citation search, 37 articles were selected for inclusion in this review, accounting for a total of 37 patients. According to the JBI Critical Appraisal Checklist for Case Reports, 7 case reports were of high quality and 12 of low quality. The overall evidence of quality of the case reports was moderate, and 51.6% of patients developed hemodynamic compromise or showed signs of cardiac tamponade. The main underlying cause for the development of pneumopericardium was issues relating to the catheter drainage system; 64.9% of cases required decompressive therapy. Conclusions: Pneumopericardium can occur as a complication after pericardiocentesis and must therefore be considered in symptomatic patients. While detection by transthoracic echocardiography is difficult and relies on non-validated signs, chest X-ray and computed tomography can provide a definitive diagnosis.https://www.mdpi.com/2308-3425/12/7/246pneumopericardiumpericardiocentesisechocardiographyair gapswirling bubblecase report |
| spellingShingle | Andreas Merz Hong Ran Cheng-Ying Chiu Henryk Dreger Daniel Armando Morris Matthias Schneider-Reigbert Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report Journal of Cardiovascular Development and Disease pneumopericardium pericardiocentesis echocardiography air gap swirling bubble case report |
| title | Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report |
| title_full | Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report |
| title_fullStr | Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report |
| title_full_unstemmed | Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report |
| title_short | Iatrogenic Pneumopericardium After Pericardiocentesis: A Systematic Review and Case Report |
| title_sort | iatrogenic pneumopericardium after pericardiocentesis a systematic review and case report |
| topic | pneumopericardium pericardiocentesis echocardiography air gap swirling bubble case report |
| url | https://www.mdpi.com/2308-3425/12/7/246 |
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