Cardiac Tamponade Case Study

Cardiac tamponade is one of the cardiac emergencies which necessitates an urgent diagnosis and treatment to restore haemodynamics. Causes of tamponade may vary in etiology however almost all of them have a common clinical presentation. Spontaneous hemopericardium leading to cardiac tamponade is an unusual manifestation of thrombocytopenia and to the best of our knowledge ,there is no case of thrombocytopenic tamponade mentioned in the literature. We report a case of 64-years-old female who presented with cardiactamponade after coronary artery bypass surgery, as a probable result of an idiopathic thrombocytopenic episode and required emergent revision surgery.

1. Introduction

Pericardial pathology is commonly encountered in clinical practice and may present either as an isolated process or in association with other systemic disorders. Only a part of cases

Actually, it is the most frequent cause of bleeding abnormalities. Petechia ,purpura and mucosal bleeding are among its typical clinical findings. Moreover, severe and life threatening gastrointestinal or intracranial bleeding may also ensue. To rule out other coagulation defects, laboratory tests must show a prolonged bleeding time in the presence of normal coagulation parameters and thrombocytopenia . There are several mechanisms of thrombocytopenia. The major scenarios are decreased production and increased destruction of thrombocytes, or both. The major goal of diagnostic procedures should be to reveal the underlying pathologies. Examination of the bone marrow and the peripheral blood smear can be useful as well as special diagnostic tests of the assumed defect. First line therapies should target the underlying disease, however platelet transfusions may also be mandatory up to some extend. However, in case of diseases with increased platelet activation and consumption, platelet transfusion is not convenient because it may trigger a new pathologic