Dr.Phool Iqbal
Resident physician,Hamad Medical Corporation, Internal Medicine, Doha, Qatar
Title: Cardiac Tamponade: An unusual cause of a severe headache with normal blood pressure
Biography
Biography: Dr.Phool Iqbal
Abstract
Cardiac tamponade is a life-threatening condition characterized by slow or rapid compression of the heart due to the accumulation of fluid in the pericardial space and rarely presents mainly as a headache.
We report an unusual presentation of cardiac tamponade associated mainly with severe headache from 3 days and mild shortness of breath in a 60-year-old male not known to have any previous heart disease. Immediate CT scan of the head ruled out intracranial hemorrhage. Chest XR showed cardiomegaly and further echocardiography revealed large pericardial effusion on a transthoracic echocardiogram compromising right ventricular output. Urgent pericardiocentesis was performed and removed 800ml of hemorrhagic fluid that led to a complete resolution of severe headache. All the work up for hemorrhagic pericardial effusion, including Tuberculosis, malignancy and autoimmune screening was negative. PET scan was also unremarkable for any foci of increased uptake. We labelled our case as idiopathic myocarditis complicated with hemorrhagic pericardial effusion, based on Cardiac MRI which revealed features suggestive of Myocarditis or cardiomyopathy.
Headache as the main presentation of a fatal condition like cardiac tamponade without any underlying secondary cause is quite uncommon to find in the literature. Therefore makes it an important reportable case.