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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| Format: | Article |
| Language: | English |
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American College of Physicians
2023-08-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2022.1351 |
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| _version_ | 1849698781263560704 |
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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. |
| format | Article |
| id | doaj-art-a4c8ddc015d34cbbaa43e8086ba106b3 |
| institution | DOAJ |
| issn | 2767-7664 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | American College of Physicians |
| record_format | Article |
| 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 |
| work_keys_str_mv | AT zechenma systemiclupuserythematosusinitialmanifestationascardiactamponade AT xiaoyanglan systemiclupuserythematosusinitialmanifestationascardiactamponade AT kevinrbainey systemiclupuserythematosusinitialmanifestationascardiactamponade |