Department of Intensive Care Unit, Hospital Fernando Fonseca, Portugal
Case Report
Cardiac Tamponade: Look for Pulsus Paradoxus in the Arterial Line
Author(s): Monica Palma Anselmo* and Lisete Rolo Nunes
Cardiac tamponade is a life-threatening condition with a myriad of etiologies. The diagnosis is challenging and when
left undiagnosed and untreated this results in a significant mortality. We present a case of a sixty-nine-year-old male
with a history of stage IV breast cancer that was hospitalized with a recurrent right-side pleural effusion. A thoracocentesis
was performed, and the drain removed five days after. As a complication he had extensive subcutaneous
emphysema. On the day of the ICU admission, he became obnubilated, with worsening of hypoxemia, hypotensive
and anuric. High flow nasal cannula and norepinephrine were started. A right-side chest drain was inserted. Despite
the slight improvement in oxygenation, the patient remained in shock. The arterial line showed pulsus paradoxus
leading to the suspicion of cardiac tamponade. The exuberant emphysema mad.. View More»
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