Haemorrhagic cardiac tamponade: a rare complication of pneumonia

Abstract

A 78-year-old female presented with a cough and flu-like symptoms of 1-week duration. Examination revealed her to be febrile (38.2°C), hypoxic (oxygen saturation of 87% in room air) and marginally hypotensive (108/50 mmHg). Respiratory examination revealed a dull percussion note, coarse crepitations and bronchial breath sounds at the left base. The heart sounds were noted to be quiet. Investigations showed neutrophilia (10.3 × 109/l), ESR 101 mm/h, CRP 241 mg/l, sodium 122 mmol/l, urea 11.5 mmol/l and creatinine 116 μmol/l. Chest X-ray on admission showed a left basal infiltrate, a flask-shaped heart and left pleural effusion. ECG showed small voltage complexes. …