{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T23:48:40Z","timestamp":1740181720463,"version":"3.37.3"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Egypt Heart J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Nowadays, percutaneous procedures are expanding in use, and this comes with complications associated with the procedure itself. Cardiac tamponade is rare but may be life threatening since it can involve hemodynamic instability. It is known that after pleural effusion during a percutaneous procedure, pericardiocentesis should be used as drainage of the cavity. However, that does not achieve hemostasis in some cases, and in those patients who are hemodynamically unstable, a sealing agent to promote hemostasis might be useful, like thrombin.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present a case report of 89-year-old patient with history of melanoma undergoing treatment with pembrolizumab, who attended the emergency department referring chest pain (intensity 5\/10) and palpitations that have lasted hours. He had TnTUs 554\/566\u00a0ng\/L and an echocardiogram that showed dilated right chambers, hypertrophy and global hypokinesia of the left ventricle, increased filling pressures of the left ventricle and pulmonary hypertension. Myocarditis associated with pembrolizumab was suspected, so high dose steroids were initiated and endomyocardial biopsy was conducted, resulting in iatrogenic cardiac tamponade. To determine the etiology of the suspected myocarditis, an endomyocardial biopsy was performed. Unfortunately, an intraprocedural complication arose: pleural effusion resulting in iatrogenic cardiac tamponade, leading to hemodynamic instability. It required immediate pericardial drainage via subxiphoid puncture, obtaining a 550\u00a0mL hematic debit. Clinical manifestations raised suspicion of tamponade, prompting a bedside echocardiogram for a definitive diagnosis. Despite these efforts, the patient remained hemodynamically unstable, and due to the elevated surgical risk, intrapericardial thrombin was employed to achieve successful hemostasis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Cardiac tamponade is a life-threatening condition that can sometimes be induced iatrogenically, resulting from percutaneous interventions. Despite limited evidence regarding this therapeutic strategy, in patients experiencing iatrogenic cardiac tamponade with hemodynamic instability and high surgical risk, the administration of intra-pericardial thrombin could be contemplated.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s43044-024-00459-5","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T10:02:54Z","timestamp":1708941774000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intra-pericardial thrombin injection in iatrogenic cardiac tamponade: a case report"],"prefix":"10.1186","volume":"76","author":[{"given":"Juana Perez","family":"Morales","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Spaccavento","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Ordo\u00f1ez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roc\u00edo","family":"Baro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6518-8823","authenticated-orcid":false,"given":"Diego","family":"Conde","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Pablo","family":"Costabel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"issue":"6","key":"459_CR1","doi-asserted-by":"publisher","first-page":"euad140","DOI":"10.1093\/europace\/euad140","volume":"25","author":"G Von Olshausen","year":"2023","unstructured":"Von Olshausen G, Tabrizi F, Sigurj\u00f3nsd\u00f3ttir R, Ringborn M, H\u00f6glund N, Hassel J\u00f6nsson A, Holmqvist F, Braunschweig F (2023) Cardiac tamponades related to interventional electrophysiology procedures are associated with higher risk of short-term hospitalization for pericarditis but favourable long-term outcome. Europace 25(6):euad140. https:\/\/doi.org\/10.1093\/europace\/euad140","journal-title":"Europace"},{"issue":"8","key":"459_CR2","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1016\/j.jcin.2009.04.019","volume":"2","author":"DR Holmes Jr","year":"2009","unstructured":"Holmes DR Jr, Nishimura R, Fountain R, Turi ZG (2009) Iatrogenic pericardial effusion and tamponade in the percutaneous intracardiac intervention era. JACC Cardiovasc Interv 2(8):705\u2013717. https:\/\/doi.org\/10.1016\/j.jcin.2009.04.019","journal-title":"JACC Cardiovasc Interv"},{"issue":"5","key":"459_CR3","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1002\/joa3.12911","volume":"39","author":"S Deshpande","year":"2023","unstructured":"Deshpande S, Swatari H, Ahmed R, Collins G, Khanji MY, Somers VK, Chahal AA, Padmanabhan D (2023) Predictors of morbidity and in-hospital mortality following procedure-related cardiac tamponade. J Arrhythm 39(5):790\u2013798. https:\/\/doi.org\/10.1002\/joa3.12911","journal-title":"J Arrhythm"},{"issue":"4","key":"459_CR4","doi-asserted-by":"publisher","first-page":"337","DOI":"10.1177\/2048872612460966","volume":"1","author":"JK Lee","year":"2012","unstructured":"Lee JK, Tsui KL, Chan KK, Li SK (2012) Intra-pericardial thrombin injection for post-infarction left ventricular free wall rupture. Eur Heart J Acute Cardiovasc Care 1(4):337\u2013340. https:\/\/doi.org\/10.1177\/2048872612460966","journal-title":"Eur Heart J Acute Cardiovasc Care"},{"issue":"2","key":"459_CR5","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s12471-022-01701-y","volume":"31","author":"D Rottl\u00e4nder","year":"2023","unstructured":"Rottl\u00e4nder D, Saal M, Degen H, Haude M (2023) Intra-pericardial thrombin injection as bailout strategy in iatrogenic pericardial tamponade. Neth Heart J 31(2):61\u201367. https:\/\/doi.org\/10.1007\/s12471-022-01701-y","journal-title":"Neth Heart J"},{"issue":"5","key":"459_CR6","doi-asserted-by":"publisher","first-page":"429","DOI":"10.4065\/77.5.429","volume":"77","author":"TS Tsang","year":"2002","unstructured":"Tsang TS, Enriquez-Sarano M, Freeman WK, Barnes ME, Sinak LJ, Gersh BJ, Bailey KR, Seward JB (2002) Consecutive 1127 therapeutic echocardiographically guided pericardiocenteses: clinical profile, practice patterns, and outcomes spanning 21 years. Mayo Clin Proc 77(5):429\u2013436. https:\/\/doi.org\/10.4065\/77.5.429","journal-title":"Mayo Clin Proc"},{"key":"459_CR7","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/j.jcrc.2016.12.008","volume":"39","author":"P McCanny","year":"2017","unstructured":"McCanny P, Colreavy F (2017) Echocardiographic approach to cardiac tamponade in critically ill patients. J Crit Care 39:271\u2013277. https:\/\/doi.org\/10.1016\/j.jcrc.2016.12.008","journal-title":"J Crit Care"}],"container-title":["The Egyptian Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00459-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s43044-024-00459-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s43044-024-00459-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T10:02:57Z","timestamp":1708941777000},"score":1,"resource":{"primary":{"URL":"https:\/\/tehj.springeropen.com\/articles\/10.1186\/s43044-024-00459-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,26]]},"references-count":7,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["459"],"URL":"https:\/\/doi.org\/10.1186\/s43044-024-00459-5","relation":{},"ISSN":["2090-911X"],"issn-type":[{"type":"electronic","value":"2090-911X"}],"subject":[],"published":{"date-parts":[[2024,2,26]]},"assertion":[{"value":"17 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 February 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and accompanying images. The case report was conducted in accordance with national ethical standards (CABA Law 3301) and the National Law on Clinical Research in Humans, the Declaration of Helsinki, and had the approval of the Teaching and Ethics Committee of our institution. Patient provided informed consent for the anonymous use of their data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We declare do not have any conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"28"}}