Journal: Journal of Investigative Medicine High Impact Case Reports
Article Title: Disseminated Histoplasmosis-Associated Cardiac Tamponade in a Patient With Acquired Immunodeficiency Syndrome
doi: 10.1177/23247096251342922
Figure Lengend Snippet: The patient’s bedside transthoracic echocardiogram and practical aspects of the emergent pericardiocentesis. (A) The parasternal long-axis echocardiographic view demonstrating a large circumferential pericardial effusion with tamponade physiology, demarcated by the asterisks. (B) Emergent pericardiocentesis was performed under fluoroscopy in the cardiac catheterization laboratory. The red arrow indicates a 6 French femoral Prelude ® sheath (Merit Medical Systems Inc., South Jordan, UT, USA) with a 6 French Expo™ pigtail catheter (Boston Scientific, Marlborough, MA, USA) encircled in red. (C) The sub-xiphoid approach to pericardiocentesis was performed under fluoroscopic and ultrasound-guidance. The green circle indicates the implanted 6 French femoral Prelude sheath (Merit Medical Systems Inc.) attached to a 6 French Expo pigtail catheter (Boston Scientific, Marlborough, MA, USA). (D) Our technique involved connecting the pigtail catheter to a negative suction container encircled in green, which rapidly relieved the tamponade physiology and normalized the patient’s obstructive shock. This strategy removed voluminous pericardial fluid quickly (~460 mL within 5-10 minutes).
Article Snippet: A quick, bedside, 2-dimensional transthoracic echocardiogram was performed, which revealed tamponade with a large circumferential pericardial effusion and both right atrial and ventricular collapse ( )., An emergent fluoroscopic- and ultrasound-guided sub-xiphoid pericardiocentesis was performed in the cardiac catheterization laboratory using a 6 French femoral Prelude ® sheath (Merit Medical Systems Inc.) with a 6 French ExpoTM pigtail catheter (Boston Scientific) connected to negative suction., Approximately 460 mL of straw-colored fluid was aspirated ( )., Subsequently, the patient’s hemodynamic status drastically improved with near-normalization, and the residual pericardial effusion significantly decreased with absent tamponade physiology.
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