Immediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literature
Abstract Introduction Cardiac tamponade is a life-threatening condition resulting from fluid accumulation in the pericardial sac, leading to decreased cardiac output and shock. Various etiologies can cause cardiac tamponade, including liver cirrhosis, which may be induced by autoimmune hepatitis. Au...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s13256-024-05016-x |
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| author | Maryam Taheri Arash Hassanpour Dargah Pedram Ramezani Mohsen Anafje Amir Nasrollahizadeh Pouya Ebrahimi Mohammad Hossein Mandegar |
| author_facet | Maryam Taheri Arash Hassanpour Dargah Pedram Ramezani Mohsen Anafje Amir Nasrollahizadeh Pouya Ebrahimi Mohammad Hossein Mandegar |
| author_sort | Maryam Taheri |
| collection | DOAJ |
| description | Abstract Introduction Cardiac tamponade is a life-threatening condition resulting from fluid accumulation in the pericardial sac, leading to decreased cardiac output and shock. Various etiologies can cause cardiac tamponade, including liver cirrhosis, which may be induced by autoimmune hepatitis. Autoimmune hepatitis is a chronic inflammatory liver disease characterized by interface hepatitis, elevated transaminase levels, autoantibodies, and increased immunoglobulin G levels. This case report details a 60-year-old male with autoimmune hepatitis-induced cirrhosis presenting with severe pericardial effusion and cardiac tamponade, emphasizing the interplay between liver and cardiac pathologies. Methods A 60-year-old Persian man presented with progressive dyspnea, chest pain, and significant weight gain due to fluid retention. Physical examination revealed pallor, jaundice, elevated jugular venous pressure, muffled heart sounds, and tachycardia. Laboratory tests indicated severe hepatic and renal dysfunction, with elevated liver enzymes, bilirubin, and blood urea nitrogen. Imaging studies, including electrocardiogram, computed tomography angiography, and transthoracic echocardiogram, confirmed large pericardial effusion with signs of cardiac tamponade. Emergency pericardiocentesis was performed, aspirating 500 mL of serosanguinous fluid. Post-procedural management included continuous monitoring, repeat echocardiography, and a comprehensive pharmacological regimen addressing fluid overload, autoimmune hepatitis, and cardiac function. Conclusion This case underscores the importance of timely diagnosis and management of cardiac tamponade, particularly in patients with concomitant conditions like autoimmune hepatitis and cirrhosis. Multidisciplinary management involving hepatologists, cardiologists, and critical care specialists is crucial for improving patient outcomes. Early recognition and treatment contribute substantially to the prevention of recurrence and better long-term management of underlying conditions. |
| format | Article |
| id | doaj-art-08144ed381b842cb961465c2dff647a4 |
| institution | Kabale University |
| issn | 1752-1947 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj-art-08144ed381b842cb961465c2dff647a42025-01-12T12:25:31ZengBMCJournal of Medical Case Reports1752-19472025-01-011911910.1186/s13256-024-05016-xImmediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literatureMaryam Taheri0Arash Hassanpour Dargah1Pedram Ramezani2Mohsen Anafje3Amir Nasrollahizadeh4Pouya Ebrahimi5Mohammad Hossein Mandegar6Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical SciencesSchool of Medicine, Alborz University of Medical SciencesEndocrinology and Metabolism Research Center, Tehran University of Medical SciencesRajaei Cardiovascular Medical and Research Rajaie Cardiovascular Medical and Research institute, School of Medicine, Iran University of Medical SciencesTehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical SciencesTehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical SciencesCardiac Surgery Department, Imam Khomeini Hospital, Tehran University of Medical SciencesAbstract Introduction Cardiac tamponade is a life-threatening condition resulting from fluid accumulation in the pericardial sac, leading to decreased cardiac output and shock. Various etiologies can cause cardiac tamponade, including liver cirrhosis, which may be induced by autoimmune hepatitis. Autoimmune hepatitis is a chronic inflammatory liver disease characterized by interface hepatitis, elevated transaminase levels, autoantibodies, and increased immunoglobulin G levels. This case report details a 60-year-old male with autoimmune hepatitis-induced cirrhosis presenting with severe pericardial effusion and cardiac tamponade, emphasizing the interplay between liver and cardiac pathologies. Methods A 60-year-old Persian man presented with progressive dyspnea, chest pain, and significant weight gain due to fluid retention. Physical examination revealed pallor, jaundice, elevated jugular venous pressure, muffled heart sounds, and tachycardia. Laboratory tests indicated severe hepatic and renal dysfunction, with elevated liver enzymes, bilirubin, and blood urea nitrogen. Imaging studies, including electrocardiogram, computed tomography angiography, and transthoracic echocardiogram, confirmed large pericardial effusion with signs of cardiac tamponade. Emergency pericardiocentesis was performed, aspirating 500 mL of serosanguinous fluid. Post-procedural management included continuous monitoring, repeat echocardiography, and a comprehensive pharmacological regimen addressing fluid overload, autoimmune hepatitis, and cardiac function. Conclusion This case underscores the importance of timely diagnosis and management of cardiac tamponade, particularly in patients with concomitant conditions like autoimmune hepatitis and cirrhosis. Multidisciplinary management involving hepatologists, cardiologists, and critical care specialists is crucial for improving patient outcomes. Early recognition and treatment contribute substantially to the prevention of recurrence and better long-term management of underlying conditions.https://doi.org/10.1186/s13256-024-05016-xTamponadeLiver cirrhosisAutoimmune hepatitisPericardial effusionSystemic inflammation |
| spellingShingle | Maryam Taheri Arash Hassanpour Dargah Pedram Ramezani Mohsen Anafje Amir Nasrollahizadeh Pouya Ebrahimi Mohammad Hossein Mandegar Immediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literature Journal of Medical Case Reports Tamponade Liver cirrhosis Autoimmune hepatitis Pericardial effusion Systemic inflammation |
| title | Immediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literature |
| title_full | Immediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literature |
| title_fullStr | Immediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literature |
| title_full_unstemmed | Immediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literature |
| title_short | Immediate management of a cirrhosis-induced severe pericardial effusion: a case report and review of the literature |
| title_sort | immediate management of a cirrhosis induced severe pericardial effusion a case report and review of the literature |
| topic | Tamponade Liver cirrhosis Autoimmune hepatitis Pericardial effusion Systemic inflammation |
| url | https://doi.org/10.1186/s13256-024-05016-x |
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