Clinical Practice and Cases in Emergency Medicine

Minoxidil is a strong oral vasodilator that is used to treat patients with hypertension refractoryto first-line medications. We report a case of minoxidil-associated subacute cardiac tamponadediagnosed by point-of-care ultrasound (POCUS) in a hypertensive patient. A 30-year-old male witha past medical history of poorly controlled hypertension (treated with minoxidil) and chronic kidneydisease presented with 2-3 days of chest pain and shortness of breath with markedly elevated bloodpressures. A point-of-care transthoracic echocardiogram revealed a massive pericardial effusion withsonographic tamponade physiology. We review the risk factors for developing pericardial effusionsthat progress to cardiac tamponade, the utility of diagnosing these patients by POCUS, and theincidence of patients who present with sonographic signs of cardiac tamponade without hypotension.