Case No. 1

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Case No. 1


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Chief Complaint:

Chest pain, Shortness of Breath

Published: April 19, 2017
Author: jason.lopez

A 74yo M with a history of end-stage renal disease, on hemodialysis, presents with chest pain and shortness of breath. The patient reports he missed several sessions of dialysis. You obtain EKG which shows electrical alternans and low voltage QRS complexes. The patient is tachycardic, hypotensive, and has jugular venous distention. A bedside echocardiogram shows a pericardial effusion.


Which is true regarding an emergent pericardiocentesis in this case?

  • Aspiration of dark thick blood indicates you are in the pericardial space
  • Use of ultrasound is time-consuming and should never be utilized
  • It should be performed prophylactically for patients with an effusion without evidence of cardiac tamponade
  • Pneumothorax is a complication of the procedure
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