Anticoagulant-induced hemopericardium with tamponade: A case report and review of the literature

J Clin Exp Invest 2013;4(2):229-233.

https://doi.org/10.5799/ahinjs.01.2013.02.0273

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Abstract

Acute cardiac tamponade requires urgent diagnosis and treatment. We report a case of a 43-year-old man who was receiving warfarin treatment for 8 months following mitral valve replacement. The patient had complaint of dyspnea and fatigue for a few days. Cardiac tamponade was diagnosed, and the INR at that time was 10.4. Urgent pericardiocentesis were undertaken and 1400 ml of peri­cardial blood was drained. Following surgery the patient’s recovery was uneventful. An intravenous vitamin K injec­tion and fresh frozen plasma transfusion were adminis­tered to reverse the patient’s over-anticoagulated state. The final pathology revealed chronic inflammation and there was no malignancy, and no bacteria or mycobacte­rium were seen. Emergency physicians should remember that over-anticoagulation with warfarin may contribute to certain complications, including hemopericardium, and that strict control of target INR should be the goal for pa­tients who require continuous warfarin treatment.

Keywords

Hemopericardium, tamponade, oral antico­agulation, warfarin, echocardiography

Citation

Ertaş F, Polat N, Yıldız A, Oylumlu M, Ülgen MS. Anticoagulant-induced hemopericardium with tamponade: A case report and review of the literature. J Clin Exp Invest. 2013;4(2):229-33. https://doi.org/10.5799/ahinjs.01.2013.02.0273