Anaesthetic management of post-PTCA cardiac tamponade from cath lab to cardiothoracic operating theater

Abstract

Cardiac tamponade is a medical emergency characterized by the accumulation of fluid in the pericardial sac, exerting pressure on the heart and impairing its ability to pump blood effectively. This condition can result from various causes, including trauma, infection, malignancy, or complications of medical procedures such as percutaneous coronary interventions (PCI) like percutaneous transluminal coronary angioplasty (PTCA). The anaesthesiologists play a pivotal role as peri operative physicians in the catheterization laboratory and intensivists in the ICU in prompt recognition and intervention which is crucial to prevent hemodynamic collapse and improve patient outcomes. In this case, a female in her fifties with a history of previous PCI developed cardiac tamponade shortly after undergoing PTCA. Despite immediate stabilization attempts in the catheterization laboratory, the patient's condition deteriorated rapidly, necessitating emergency pericardiocentesis and subsequent thoracotomy for definitive management. The successful outcome of this case underscores the importance of early recognition, rapid intervention, and a multidisciplinary approach in managing cardiac tamponade post-PTCA.