Ultrasound-Guided Emergency Pericardiocentesis of a Patient with Multiple Myeloma in a Resource Limited Setting
Journal Title: Advanced Journal of Emergency Medicine - Year 2018, Vol 2, Issue 1
Abstract
Introduction: Cardiac tamponade, a variant of cardiogenic shock, is a medical emergency. A traumatic cardiac tamponade is an expected phenomenon; however, in non-traumatic events such as malignant pathology, it is usually less dramatic and takes several days or weeks to manifest. Occurrence of tamponade physiology due to pericardial effusion in a patient with multiple myeloma is a distinctly unusual entity. The involvement of a serous cavity in multiple myeloma is rare and pericardial effusion in such a case is due to restrictive cardiomyopathy or amyloidosis, a presentation late in the course of the disease that carries a grave prognosis. Case presentation: We present to you a case of a 60-year-old patient with cardiac tamponade due to pericardial effusion secondary to an advanced multiple myeloma. Due to the early diagnosis, she underwent a successful emergency pericardiocentesis with a central venous catheter under ultrasound guidance even in a resource limited emergency department (ED) of a district in southern India. She also showed marked improvement after the procedure and was transferred to the intensive care unit for further management. Conclusion: Cardiac tamponade is not an “all or none” phenomenon, but rather a continuum of findings. A high index of suspicion and timely clinical decision-making is the key for an emergency physician. Although there are several mimics for cardiac tamponade in ED, it is important for an emergency physician to be aware of such varied presentations of a disease spectrum owing to its rarity and clinical importance.
Authors and Affiliations
Arpith Easo Samuel, Reshma Balembi Krishna
Keywords
Related Articles
- EP ID EP378197
- DOI 10.22114/ajem.v0i0.28
- Views 115
- Downloads 0
Demography of Medical Journals in Iran; a Cross-Sectional Study
Introduction: Policymaking in order to increase the quality of medical journals needs having accurate data from their current status. Objective: The present study was designed with the aim of introducing a demographic sc...
Sample Size Calculation Guide - Part 2: How to Calculate the Sample Size for an Independent Cohort Study
In the previous article, we explained how to calculate the sample size for a cross-sectional study based on a rate or a single proportion. In this article, we will explain how to calculate the sample size for an independ...
Preparation and Implementation of Intrahospital Transfer Protocol for Emergency Department Patients to Decrease Unexpected Events
Introduction: Most of the patients hospitalized in the emergency department (ED) are in need of transfer to other hospital wards or paraclinic units. This process is called intrahospital transfer (IHT) that may lead to a...
Emergency Department Patient Satisfaction Assessment using Modified Servqual Model; a Cross-sectional Study
Introduction: The quality of medical services and attention paid to patients in medical centers have been concerning for healthcare providers. Objective: The present study was designed to identify factors affecting patie...
What Can We Do to Improve Patient Satisfactıon in the Emergency Department? A Prospective Study in a Turkish University Hospital
Introduction: In recent years, patients' satisfaction with emergency medical services provided to them has been one of the main criteria in the evaluation of the quality of these services. Objective: The goal of our stud...