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Open Access Publications from the University of California

Hemopericardium and Cardiac Tamponade in a Patient with an Elevated International Normalized Ratio

  • Author(s): Levis, Joel T
  • Delgado, Mucio C
  • et al.

This case report describes a 54-year-old male on warfarin for atrial fibrillation who presented to the emergency department (ED) following a syncopal episode with persistent hypotension. The patient’s International Normalized Ratio (INR) returned elevated at 6.0, and a rapid bedside cardiac ultrasound revealed a large pericardial effusion consistent with cardiac tamponade. The anticoagulation was reversed and the patient underwent successful pericardiocentesis with removal of 1,100 mL of blood. [WestJEM. 2009;10:115-119.]

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