Key result
Dabigatran linked to spontaneous hemopericardium and cardiac tamponade within 2 weeks of initiation.
Why the study?
Spontaneous hemopericardium as a complication of dabigatran etexilate use in atrial fibrillation patients is not well characterized.
Case Report (n=1)
Dabigatran etexilate use for atrial fibrillation may be associated with the rare but life-threatening complication of spontaneous hemopericardium and cardiac tamponade.
Alerts clinicians to possible dabigatran tamponade in AF; single case leaves incidence and causality open.
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.
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Masoomi et al. (2015) conducted a case report in Atrial fibrillation (n=1). Dabigatran etexilate was evaluated. A 66-year-old male developed spontaneous hemopericardium and cardiac tamponade requiring aspiration of 500 cc of hemorrhagic fluid 2 weeks after starting dabigatran etexilate.
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