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Cardiac tamponade in undiagnosed systemic lupus erythematosus

Tsung-Han Ho and Yi-Tin Tsai
Med J Aust 2016; 205 (3): 109. || doi: 10.5694/mja16.00286
Published online: 1 August 2016

A 22-year-old woman presented with a 3-day history of fever, retrosternal chest pain and exertional dyspnoea. Her heart rate was 130 bpm with a blood pressure level of 109/68 mmHg. Physical examination suggested tamponade: distended jugular veins, pulsus paradoxus and muffled heart tones. The chest radiography was notable for the characteristic water-bottle sign (Figure, A).1 Contrast-enhanced chest computed tomography demonstrated a massive pericardial effusion (Figure, B) associated with venous engorgement of the superior and inferior vena cava (SVC, IVC), prevascular space (arrows), and bilateral axillary veins (arrowheads). An emergency thoracoscopic pericardial window was performed and 620 mL of bloody fluid was drained.

  • Tsung-Han Ho
  • Yi-Tin Tsai

  • Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan


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