An unusual case of cardiac tamponade following electrical cardioversion

Our plain-English summary of An unusual case of cardiac tamponade following electrical cardioversion, by G.A. Jessurun, H.J. Crijns, J. van Wijngaarden (International Journal of Cardiology, 1996).

The study

• Authors: G.A. Jessurun, H.J. Crijns, J. van Wijngaarden
• Journal: International Journal of Cardiology
• Published: 1996;53(3):317-20
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The clinical presentation of cardiac tamponade may uncover underlying pericardial disease. We describe a patient who was being treated for lone atrial fibrillation. In this case, direct current cardioversion for recurrence of atrial fibrillation was complicated by a life-threatening hemopericardium. A history of asbestos exposure was subsequently related to the subclinical pericarditis.

In plain English

This case report, from the Department of Cardiology at University Hospital Groningen in the Netherlands, described one 56-year-old man. He had been treated for four years for lone atrial fibrillation, an irregular heart rhythm, and had undergone several electrical cardioversions (shocks to reset the rhythm). Three days after a successful cardioversion, he was admitted with rapidly worsening breathlessness and a 7 kg weight gain. Ultrasound showed a 5 cm pericardial effusion, meaning fluid around the heart. The drained fluid was bloody and its cells looked normal. His listed risk factors were cigarette smoking and asbestos exposure; the article gave no details of the exposure. A CT scan showed calcified pleura at the base of the right lung. Doctors first suspected lymphoma or mesothelioma and removed a severely thickened pericardium. Tissue examination showed non-specific chronic inflammation, with no asbestos bodies and no cancer. He recovered, but six months later he was breathless on exertion, and ultrasound was compatible with constrictive pericarditis. The authors concluded it was reasonable to assume his asbestos exposure was related to his hidden pericarditis, but said a viral cause could not be entirely excluded.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 56-year-old man with a 4-year history of lone atrial fibrillation, treated at University Hospital Groningen, Department of Cardiology, the Netherlands; dates of care not stated (article received November 1995)
• Exposure: Asbestos exposure listed as a risk factor, alongside cigarette smoking; no fiber type, job, duration or dose given. The event followed direct current electrical cardioversion.
• Main results:
  • The patient was admitted with rapidly progressive breathlessness and a 7 kg weight gain, 3 days after a successful electrical cardioversion.
  • Echocardiography showed a 5 cm pericardial effusion with inflow obstruction.
  • Pericardial drainage produced a bloody (hemorrhagic) effusion with normal cytology.
  • CT of the chest showed calcified pleura at the right base; no lymphoma was visible.
  • At surgery a severely thickened pericardium was removed; tissue showed non-specific chronic inflammation and organised fibrin, with no asbestos bodies or malignancy.
  • The calcified pleura showed non-specific degenerated tissue.
  • Six months after discharge the patient had breathlessness on exertion, and repeated echocardiography was compatible with constrictive pericarditis.
• The authors' conclusion: The authors concluded it was reasonable to assume that the patient's asbestos dust exposure was related to his subclinical pericarditis, even though no asbestos bodies were found in the tissue.
• Limitations the authors state:
  • The authors stated that an unrecognised viral pericarditis could not be entirely excluded as the cause.
  • No asbestos bodies were found in the examined tissue.

Topics

Medical terms in this study, explained in our Lexicon: Cardiac Tamponade, Pericardial, Asbestos Exposure.

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