More than Meets the Eye: An Interesting Case of Cardiac Tamponade

Abstract

This interesting case highlights the presentation of a 68-year-old Latino male with coronary artery disease and coronary artery bypass graft surgery eight years who presented with non-specific respiratory symptoms. At the time of his initial evaluation he was noted to have persistent bigeminy and a 5 beat run of ventricular tachycardia. During his hospital stay he was again noted to have marked arrhythmias, with a 40 beat run of ventricular tachycardia. Urgent echocardiogram was obtained and revealed significant pericardial effusion compressing his right ventricle. On cardiac catheterization patient was found to have a patent graft but trasudative pericardial fluid causing tamponade and arrhythmia both which completely resolved after drainage. Learning Objective 1: Recognize ventricular arrhythmias as an atypical presentation of pericardial effusion and cardiac tamponade. Learning Objective 2: Appreciate the utility of echocardiogram in elucidating etiologies of non-sustained ventricular tachycardia.