Abstract
Pericardial effusion is an important cardiac condition seen in clinical practice with several known underlying etiologies. We are aware of the challenge that exists in diagnosing the effusion. An interesting challenge that has caught our attention is the highest chance of missing the diagnosis if there is an atypical clinical presentation of the patient. In this case report, our objective is to discuss a case that enhances the importance of careful and meticulous investigation of a patient with an atypical clinical picture. This is a case report of a 92-year-old woman who presented to the emergency department with a chief complaint of upper back pain for a few days. She was found to have cardiomegaly on further imaging. An echocardiogram showed a moderate size pericardial effusion. Pericardiocentesis was done and a drain was left in place. Of note, the patient reported remarkable resolution of the back pain after the fluid was taken out. The serial echocardiogram post pericardiocentesis showed minimal drainage, hence the drain was taken out, and the patient was observed for clinical monitoring 24 hours post drain removal. A timely diagnosis and treatment saved our patient from the most dreadful life-threatening condition along with a secure discharge from the hospital.
Highlights
Pericardial effusion is the accumulation of excessive fluid in the pericardial sac around the heart
Pericardial effusion may be suspected from history, physical examination, electrocardiogram, and chest radiograph
Since pericardial effusion is possible across all ages and populations and the predominant etiology is variable, careful and thorough history, physical examination, and diagnostic approach are essential for patient care
Summary
Pericardial effusion is the accumulation of excessive fluid in the pericardial sac around the heart. The pericardial fluid may contain malignant cells or infectious organisms based on the underlying etiology. Pericardial effusion may be suspected from history, physical examination, electrocardiogram, and chest radiograph. Most patients without hemodynamically significant pericardial effusion will have no symptoms specific to the effusion but may present with symptoms related to the underlying cause [3]. Since pericardial effusion is possible across all ages and populations and the predominant etiology is variable, careful and thorough history, physical examination, and diagnostic approach are essential for patient care. There are not many studies done to show the association between upper back pain as presentation and pericardial effusion as underlying etiology. In the context of having very little data regarding the prevalence and incidence of atypical presentation in pericardial effusion, our case report emphasizes the importance of a clinician’s judgment in challenging situations. A timely diagnosis and treatment of the effusion can be a life-saving event for some of the most acute patient case scenarios
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
