Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?

A 49-year-old man presented with 1 hour of retrosternal chest pain and ST-segment elevation. In the ambulance, he was diagnosed with an ST-segment elevation myocardial infarction and received prompt fibrinolysis. On arrival to the percutaneous coronary intervention–capable hospital, he became hemody...

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Main Authors: Zechen Ma, Xiaoyang Lan, Kevin R. Bainey
Format: Article
Language:English
Published: American College of Physicians 2023-08-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2022.1351
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author Zechen Ma
Xiaoyang Lan
Kevin R. Bainey
author_facet Zechen Ma
Xiaoyang Lan
Kevin R. Bainey
author_sort Zechen Ma
collection DOAJ
description A 49-year-old man presented with 1 hour of retrosternal chest pain and ST-segment elevation. In the ambulance, he was diagnosed with an ST-segment elevation myocardial infarction and received prompt fibrinolysis. On arrival to the percutaneous coronary intervention–capable hospital, he became hemodynamically unstable, and bedside echocardiogram demonstrated a posterior pericardial effusion with tamponade physiology. He was found be profoundly thrombocytopenic secondary to a history of immune thrombocytopenic purpura (not known at the time of prehospital fibrinolysis). Given the position of his pericardial effusion, emergent surgical drainage was performed without complication. Subsequent work-up confirmed effusive pericarditis as his presenting diagnosis secondary to systemic lupus erythematosus.
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-a4c8ddc015d34cbbaa43e8086ba106b32025-08-20T03:18:49ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642023-08-012810.7326/aimcc.2022.1351Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?Zechen Ma0Xiaoyang Lan1Kevin R. Bainey21Department of Medicine, University of Alberta, Edmonton, Alberta, Canada1Department of Medicine, University of Alberta, Edmonton, Alberta, Canada2Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, CanadaA 49-year-old man presented with 1 hour of retrosternal chest pain and ST-segment elevation. In the ambulance, he was diagnosed with an ST-segment elevation myocardial infarction and received prompt fibrinolysis. On arrival to the percutaneous coronary intervention–capable hospital, he became hemodynamically unstable, and bedside echocardiogram demonstrated a posterior pericardial effusion with tamponade physiology. He was found be profoundly thrombocytopenic secondary to a history of immune thrombocytopenic purpura (not known at the time of prehospital fibrinolysis). Given the position of his pericardial effusion, emergent surgical drainage was performed without complication. Subsequent work-up confirmed effusive pericarditis as his presenting diagnosis secondary to systemic lupus erythematosus.https://www.acpjournals.org/doi/10.7326/aimcc.2022.1351
spellingShingle Zechen Ma
Xiaoyang Lan
Kevin R. Bainey
Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?
Annals of Internal Medicine: Clinical Cases
title Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?
title_full Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?
title_fullStr Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?
title_full_unstemmed Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?
title_short Systemic Lupus Erythematosus: Initial Manifestation as Cardiac Tamponade?
title_sort systemic lupus erythematosus initial manifestation as cardiac tamponade
url https://www.acpjournals.org/doi/10.7326/aimcc.2022.1351
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