Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health
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.]