Cardiac Tamponade after Pacemaker Implantation

心律調節器植入後引發之心包膜填塞

10.30035/TCCM.201003.0008

許振東(Chen-Tung Hsu)；張瑞月(Rei-Yeuh Chang)；陳政康(Cheng-Kang Chen)

心包膜填塞 ； 心律調詳器 ； 心包膜穿刺術 ； Cardiac tamponade ； Pacemaker ； Pericardiocentesis

重症醫學雜誌

11卷1期（2010 / 03 / 01）

54 - 57

英文

我們報告一名在洗腎中昏厥的71歲女性。這位病人因病竇症侯群而接受經靜脈暫時性及永久性心律調節器植入。植入後，於加護病房中發生急性心包膜填塞及休克。我們施以緊急心包膜穿刺術及內科治療，成功的治癒此病人。此病例說明心包膜填塞，應該被包含在心律調節器植入後的不明原因休克之鑑別診斷中。及早的正確診斷及治療，將是治癒此類病人的不二法門。

We report a 71-year-old woman with syncope that occurred during hemodialysis. The patient underwent transvenous temporary and permanent pacemaker implantation for sick sinus syndrome. Acute cardiac tamponade with shock developed after pacemaker implantation in our intensive care unit, which was successfully managed by emergency pericardiocentesis as well as medical therapy. Our report illustrates the importance of including cardiac tamponade in the differential diagnosis of unexplained shock after pacemaker implantation. A high index of suspicion may lead to early diagnosis, which is essential to reach a good outcome.