Wichert-Schmitt Barbara, Hintenberger Rainer, Blessberger Hermann, Stelzl Patrick, Steinwender Clemens
Department of Cardiology and Medical Intensive Care, Kepler University Hospital, Medical Faculty, Johannes Kepler University, Klinik für Innere Medizin 1, Med Campus III, Krankenhausstrasse 9 Linz 4021, Austria.
Kepler University Hospital, Medical Faculty, Johannes Kepler University, Krankenhausstrasse 9, Linz 4021, Austria.
Eur Heart J Case Rep. 2025 Aug 13;9(9):ytaf388. doi: 10.1093/ehjcr/ytaf388. eCollection 2025 Sep.
Pericardial tamponade during pregnancy is rare. Diagnosis of pericardial effusion can easily be made by echocardiography. Thorough clinical assessment, laboratory testing and advanced cardiac imaging are necessary to identify the underlying cause of pericardial effusion and rule out other causes of chest pain. Most diagnostic tests and therapeutic measures are safe during pregnancy. Systemic lupus erythematosus can be diagnosed by integrating clinical features and serologic testing. Certain autoantibodies increase the risk for adverse pregnancy events and multi-disciplinary team care is essential for a favourable pregnancy outcome.
A 37-year-old previously healthy woman presented with chest pain at 24 weeks gestational age. Echocardiography revealed a large pericardial effusion, which quickly progressed to pericardial tamponade. The woman required urgent thoracoscopic pericardial drainage as the gravid uterus impaired subcostal or apical access for pericardiocentesis. The surgery was performed without complications. Serologic testing was positive for antinuclear antibodies. Rheumatology assessment revealed further clinical features of systemic lupus erythematosus, which established the diagnosis. After initiation of treatment with hydroxychloroquine and prednisone the chest pain resolved and pericardial effusion did not recur. The twin fetuses were monitored regularly by the obstetrical team and no adverse pregnancy events occurred.
Cardiologists may be the first to detect pericardial effusion as a clinical feature of rheumatologic disease. Multi-disciplinary team care leads to good pregnancy outcomes for mother and child.
孕期心包填塞较为罕见。超声心动图可轻易诊断心包积液。需进行全面的临床评估、实验室检查及先进的心脏成像，以确定心包积液的潜在病因并排除其他胸痛原因。大多数诊断检查和治疗措施在孕期是安全的。系统性红斑狼疮可通过综合临床特征和血清学检查来诊断。某些自身抗体增加不良妊娠事件的风险，多学科团队护理对良好的妊娠结局至关重要。
一名37岁既往健康的女性在孕24周时出现胸痛。超声心动图显示大量心包积液，并迅速进展为心包填塞。由于妊娠子宫妨碍了经肋下或心尖进行心包穿刺，该女性需要紧急进行胸腔镜心包引流。手术顺利完成，无并发症。血清学检查抗核抗体呈阳性。风湿科评估发现了系统性红斑狼疮的进一步临床特征，从而确诊。在开始使用羟氯喹和泼尼松治疗后，胸痛缓解，心包积液未复发。产科团队定期监测双胞胎胎儿，未发生不良妊娠事件。
心脏病专家可能是最早将心包积液作为风湿性疾病临床特征检测到的。多学科团队护理可为母婴带来良好的妊娠结局。
