Want to take quizzes and track your credits?
A 61-year-old woman with autosomal dominant polycystic kidney disease and polycystic liver disease requiring inferior vena cava (IVC) stent placement for intrahepatic caval compression from hepatic cysts developed pleuritic chest pain, shortness of breath, and syncope. Physical examination revealed cardiac tamponade physiology (blood pressure of 96/65 mm Hg, elevated jugular venous pressure with blunted Y-descent, Kussmaul sign, and distant heart sounds), and echocardiography confirmed a large circumferential pericardial effusion, diastolic right ventricular collapse, exaggerated respiratory variation (>25%) in the mitral inflow velocity, and normal IVC size. Pericardiocentesis returned bloody fluid. Gated cardiac computed tomography angiography showed her IVC stent fractured in multiple places with its tines protruding through the IVC into the pericardial space, causing hemopericardium. Her tamponade resolved with the pericardiocentesis, and she was treated conservatively with observation. Click the article link for more case details and additional videos.
JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC
CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
You currently have no searches saved.
You currently have no courses saved.