Cardiac Perforation Caused by Cement Embolus After Total Hip Replacement

Abstract

A 77-year-old woman was transferred to our hospital with persistent chest pain. She had no previous history of coronary heart disease. Two months earlier, she had undergone a complication-free hip replacement surgery with a cemented prosthesis. On admission, she was nearly asymptomatic, but because of elevated cardiac troponin and ST-segment elevation in the inferior and lateral leads, a coronary angiography was performed, which showed normal coronary arteries. However, fluoroscopy revealed a thin, opaque structure apparently overlying the heart. After 2 hours of observation, signs and symptoms of pericarditis were noted, and shortly thereafter, worsening ensued with progression to cardiac tamponade. After percutaneous evacuation of 250 mL blood from the pericardial cavity, her clinical condition normalized. A computed tomography scan was performed …