Cardiac tamponade in a patient with chagas disease and pericardiocentesis. Case report

Abstract

Introduction: Cardiac tamponade is considered a medical emergency, which is characterized by the accumulation of fluid, pus, blood or clots in the pericardial space. Chagas disease is considered one of the potential causes of cardiac tamponade due to the myocarditis and pericarditis it can produce.
Clinical case: 58-year-old male patient who went to the emergency department, with a condition characterized by: dizziness, fatigue, productive cough with whitish expectoration, moderate dyspnea, general and mild chest discomfort. With a history of Chronic Chagas, smoker. A P-A chest x-ray, electrocardiogram and transthoracic echocardiogram were performed, confirming the diagnosis of cardiac tamponade. 
Discussion: Although Beck's triad can guide the diagnosis, it occurs in a small percentage of cases. In our case, after diagnosis, ultrasound-guided pericardiocentesis was performed and allowed the evacuation of blood content, improving the hemodynamic condition after performing the procedure and stable vital parameters. 
Conclusions: Chronic Chagas and some associated risk factors triggered the development of plugging. The pericardiocentesis was successful, allowing the evacuation of blood content, improving the hemodynamic condition and avoiding complications. Atypical presentation requires multidisciplinary management, early diagnosis related to clinical and ultrasound findings are essential for management, these will be determining factors in the evolution and prognosis of our patients