Cardiac Tamponade During Anticoagulation

ANTICOAGULATION producing a hemorrhagic cardiac tamponade in the presence of pericarditis is well documented.¹⁻⁹Even though pericarditis is mentioned as a contraindication to anticoagulation, there is no alternative treatment when anticoagulation is clearly needed for a life-threatening situation. This report of a patient with phlegmasia cerulea dolens and hemopericardium illustrates this problem. Report of a Case A 49-year-old woman was referred because of roentgenographic evidence of interstitial lung changes associated with a two-month history of increasing dyspnea, a cough productive of scanty sputum, fatigue, generalized aches, anorexia, and a 4-kg weight loss. She had not experienced fever, chills, night sweats, or hemoptysis. She had smoked one to two packs of cigarettes a day for the past 15 years. There was no history of industrial exposure or exposure to noxious agents. Physical examination at the time of admission showed a blood pressure of 90/64 mm Hg, the pulse was 84