Caiati Carlo, Pollice Paolo, Truncellito Luigi, Lepera Mario Erminio, Favale Stefano
Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantations, University of Bari "Aldo Moro", 70121 Bari, Italy.
Unit of Cardiology, Civil Hospital "Giovanni Paolo II", 75025 Policoro (MT), Italy.
Diagnostics (Basel). 2020 Mar 30;10(4):191. doi: 10.3390/diagnostics10040191.
We report the case of a 51-year-old patient who underwent the implantation of a bi-ventricular implantable cardioverter defibrillator (ICD) complicated by a sub-acute right ventricular minimal perforation with pericardial effusion and echocardiographic signs of tamponade. A new echocardiographic plane orientation allowed us to diagnose this condition in emergency and to make the right decision without delay, which consisting in unscrewing the active fixation screw under fluoroscopy guidance, while the pericardiocentesis was postponed. Thanks to the intervention focused on eliminating the cause of the postcardiac injury syndrome, the patient recovered rapidly and ultimately avoided the pericardiocentesis procedure.
我们报告了一例51岁患者的病例，该患者接受了双心室植入式心脏复律除颤器（ICD）植入术，术后出现亚急性右心室微小穿孔并伴有心包积液及超声心动图显示的心脏压塞征象。一种新的超声心动图平面取向使我们能够在紧急情况下诊断出这种情况，并立即做出正确决策，即在透视引导下拧下主动固定螺钉，同时推迟心包穿刺术。由于采取了旨在消除心脏损伤后综合征病因的干预措施，患者迅速康复，最终避免了心包穿刺术。
