Case Report

Asymptomatic Pneumopericardium with Atrial Fibrillation after Pericardiocentesis: A Case Report

Abstract

Air inside the pericardial cavity is called “pneumopericardium”, which is a rare complication of pericardiocentesis. Pneumopericardium may resolve spontaneously or can complicate into tension pericardium, requiring urgent aspiration. We herein describe a 55-year-old man with pericardial effusion who underwent pericardiocentesis. The patient was completely asymptomatic after the procedure. Chest radiograph and computed tomography scan accidentally detected pneumopericardium, which was subsequently complicated by atrial fibrillation and necessitated pharmacological cardioversion. We found no case of asymptomatic pneumopericardium complicated by atrial fibrillation after pericardiocentesis in our literature review. Clinicians and cardiologists should do a post pericardiocentesis chest X-ray to diagnose pneumopericardium and prevent the catastrophic complications of tension pneumopericardium.

Sanaei-Zadeh H, Aghakhani K. Neonatal pneumopericardium. J Perinat Med. 2006;34(1):89.

Konijn AJ, Egbers PH, Kuiper MA. Pneumopericardium should be considered with electrocardiogram changes after blunt chest trauma: a case report. J Med Case Rep. 2008 Apr 4;2:100. doi: 10.1186/1752-1947-2-100.

Narins CR, Lee J, Cole M, Ling FS. Pneumopericardium Following Pericardiocentesis. American Journal of medicine. Sept 2016;129(9):e181-182.

DOI: https://doi.org/10.1016/j.amjmed.2016.03.033

Kim HR, Choi D, Chung JW, Youn YN, Shim CY. Tension pneumopericardium after removal of pericardiocentesis drainage catheter. Cardiol J. 2009;16:477–478

Spodick DH. The technique of pericardiocentesis. When to perform it and how to minimize complications. J Crit Illn. 1995 Nov;10(11):807-12.

Buchanan CL, Sullivan VV, Lampman R, Kulkarni MG. Pericardiocentesis with extended catheter drainage: an effective therapy. Ann Thorac Surg. 2003;76:817–820.

Choi WH, Hwang YM, Park MY, Lee SJ, Lee HY, Kim SW. Pneumopericardium as a Complication of Pericardiocentesis. Korean Circ J. 2011 May;41(5):280–282. doi:10.4070/kcj.2011.41.5.280

Brander L, Ramsay D, Dreier D, Peter M, Graeni R. Continuous left hemidiaphragm sign revisited: a case of spontaneous pneumopericardium and literature review. Heart. 2002;88:e5.

Nair MKK, Namboodiri N, Banavalikar B, Gopalakrishnan A, Prasad S, Valaparambil A, et al. Iatrogenic Pneumopericardium After Pericardiocentesis. J Invasive Cardiol. 2016 Dec;28(12):E225-E226.

Files
IssueVol 14 No 3 (2019): J Teh Univ Heart Ctr QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/jthc.v14i3.1432
Keywords
Pericardial effusion Pericardiocentesis Pneumopericardium Atrial fibrillation
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Shah H, Salahudin M, Altaf A. Asymptomatic Pneumopericardium with Atrial Fibrillation after Pericardiocentesis: A Case Report. J Tehran Heart Cent. 2019;14(3):134-137.