A 66-year-old male who presented to ED with chest pain associated with
shortness of breath. At presentation, he was found to be in atrial fibrillation
(A-fib) with rapid ventricular rate (RVR). A-fib converted spontaneously
to normal sinus rhythm (NSR). However, he remained tachycardic, hypotensive
and dyspneic. A stat chest computed tomography scan (CT) was
performed and showed large pericardial effusion with Hounsfield units of
12 in the anterior pocket and 21 in the posterior pocket. A beside echocardiography
was performed, and was consistent with cardiac tamponade. Pt
was taken emergently to cardiac catheterization lab for pericardiocentesis.
500 cc of hemorrhagic pericardial fluid was aspirated, and hemodynamics
improved immediately. Approximately 2 weeks prior to the admission, the
patient had been started on dabigatran etexilate (Pradaxa) for newly diagnosed
non-valvular paroxysmal atrial fibrillation.
Key words: Atrial fibrillation, Pardaxa, Oral anticoagulant, Hemopericardium,Dabigatran Etexilate.