A rare case of cardiac tamponade due to tuberculosis

Abstract

Pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function. A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. Pericardial effusion usually results from a disturbed equilibrium between the production and re-absorption of pericardial fluid, or from a structural abnormality that allows fluid to enter the pericardial cavity. Tuberculosis involvement of the pericardium is well-known and can result in pericardial tamponade apart from other sequelae like constrictive pericarditis. Here we report a case of 60 years old female of pleuropericardial effusion presented with acute onset breathlessness, palpitation, tachypnea. Urgent echocardiography shows cardiac tamponade. Pericardiocentesis was performed immediately and more than one litre hemorrhagic fluid drained. Patient was put on anti-tubercular treatment with oral steroid after adenosine deaminase positivity in exudative pericardial fluid. Patient is doing well in follw-up visit.