A Rare Case of Left Internal Mammary Artery Transection During Pericardiocentesis

Q4 Medicine

JACC. Case reports Pub Date : 2025-06-25 DOI:10.1016/j.jaccas.2025.104041

Shaun Abid MD , Anton Stolear MD , Lila Kaminsky MD , Samdish Sethi MD , David Narotsky MD , Chirag Shah MD , Matthew Seigerman MD

{"title":"A Rare Case of Left Internal Mammary Artery Transection During Pericardiocentesis","authors":"Shaun Abid MD , Anton Stolear MD , Lila Kaminsky MD , Samdish Sethi MD , David Narotsky MD , Chirag Shah MD , Matthew Seigerman MD","doi":"10.1016/j.jaccas.2025.104041","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Pericardiocentesis is a common procedure for managing pericardial effusions, but it carries risks for vascular injury, particularly in patients with coagulopathies.</div></div><div><h3>Case Summary</h3><div>A 72-year-old man with factor V Leiden mutation and sick sinus syndrome (status post pacemaker placement), presented with dizziness, dyspnea, and chest pain. Echocardiography revealed a large pericardial effusion with tamponade physiology, necessitating pericardiocentesis. After drain removal, the patient developed hypotension and bradycardia. Imaging identified active bleeding from a distal branch of the left internal mammary artery (LIMA). Hemostasis was achieved via embolization and microcoil placement. The patient recovered with no reaccumulation of effusion or hematoma.</div></div><div><h3>Discussion</h3><div>This rare case of LIMA injury following pericardiocentesis highlights an underrecognized complication, particularly in patients with coagulation disorders. It underscores the need for vigilant postprocedural monitoring and the role of advanced imaging in diagnosing vascular injuries.</div></div><div><h3>Take-Home Message</h3><div>LIMA injury is a rare but serious complication of pericardiocentesis, requiring prompt-recognition and intervention.</div></div>","PeriodicalId":14792,"journal":{"name":"JACC. Case reports","volume":"30 16","pages":"Article 104041"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"JACC. Case reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666084925008228","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Pericardiocentesis is a common procedure for managing pericardial effusions, but it carries risks for vascular injury, particularly in patients with coagulopathies.

Case Summary

A 72-year-old man with factor V Leiden mutation and sick sinus syndrome (status post pacemaker placement), presented with dizziness, dyspnea, and chest pain. Echocardiography revealed a large pericardial effusion with tamponade physiology, necessitating pericardiocentesis. After drain removal, the patient developed hypotension and bradycardia. Imaging identified active bleeding from a distal branch of the left internal mammary artery (LIMA). Hemostasis was achieved via embolization and microcoil placement. The patient recovered with no reaccumulation of effusion or hematoma.

Discussion

This rare case of LIMA injury following pericardiocentesis highlights an underrecognized complication, particularly in patients with coagulation disorders. It underscores the need for vigilant postprocedural monitoring and the role of advanced imaging in diagnosing vascular injuries.

Take-Home Message

LIMA injury is a rare but serious complication of pericardiocentesis, requiring prompt-recognition and intervention.

查看原文本刊更多论文

心包穿刺时左乳内动脉横断1例

背景：心包穿刺是治疗心包积液的常用方法，但它有血管损伤的风险，特别是对有凝血功能障碍的患者。病例总结：一名72岁男性，Leiden因子V突变和病窦综合征（起搏器放置后状态），表现为头晕、呼吸困难和胸痛。超声心动图显示大量心包积液伴心包填塞生理征，需行心包穿刺。引流管取出后，患者出现低血压和心动过缓。影像学发现活动性出血从左内乳动脉远端分支（LIMA）。止血通过栓塞和微线圈放置。患者恢复后无积液或血肿复发。本例罕见的心包穿刺后LIMA损伤突出了一种未被认识的并发症，特别是在有凝血功能障碍的患者中。它强调需要警惕的术后监测和先进的成像诊断血管损伤的作用。心脏内膜损伤是心包穿刺术中一种罕见但严重的并发症，需要及时识别和干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊