case_images: PMC9553751_01
case_images: Admission ECG showing sinus tachycardia with right bundle branch block and right axis deviation.
case_images: CRIC2022-5440635.001.jpg
case_images: PMC9553751_01_CRIC2022-5440635.001.jpg
case_images: fig1
case_images: After central venous catheterization, CVP range was 25-30 cm H2O (Figure 1).
case_images: Admission transthoracic echocardiography showing circumferential pericardial effusion, reaching posteriorly 26 mm without compression of right atrium and ventricle. There is normal left ventricular wall thickness and contractility (LVEF > 70%). Severe right ventricular hypertrophy with flattened septum and severe PASP. There is a severe functional TR due to annulus dilatation and tethering of the tricuspid leaflets.
case_images: CRIC2022-5440635.002.jpg
case_images: PMC9553751_01_CRIC2022-5440635.002.jpg
case_images: fig2
case_images: The estimated pulmonary artery systolic pressure (PASP) was more than 115 mmHg while the left ventricle was underfilled but with a good systolic function (Figure 2).
case_images: Postpericardiocentesis follow-up transthoracic (a, b) and transesophageal (c, d) echocardiograms showing (1) normal left ventricular dimensions and systolic function, (2) dilated right-sided chambers with reduced RV function, (3) severe functional TR, and (4) no residual pericardial effusion.
case_images: CRIC2022-5440635.003.jpg
case_images: PMC9553751_01_CRIC2022-5440635.003.jpg
case_images: fig3
case_images: Emergency echocardiography revealed normal left ventricle while severely dilated right ventricle with systolic dysfunction and increased PASP more than 150 mmHg and minimal pericardial effusion (Figure 3).
case_images: Bilateral diffuse subarachnoid cisterns and intersulcal hyperdensity resembling subarachnoid hemorrhage with a left parieto-occipital cortical and subcortical hypodensity (a, b). Right frontal external ventricular drain with left parietal occipital cortical and subcortical hypodensity with loss of gray-white matter differentiation and focal hyperdensity representing infarction with hemorrhagic transformation (c). Increased cerebral edema with bilateral diffuse loss of gray-white matter differentiation of brain parenchyma (d).
case_images: CRIC2022-5440635.004.jpg
case_images: PMC9553751_01_CRIC2022-5440635.004.jpg
case_images: fig4
case_images: Withdrawal of support was done, and the patient was declared dead (Figure 4).