We report the case of a patient with cardiac tamponade and pericarditis in type B intramural hematoma. A 75-year-old woman was admitted to the emergency department presenting with general weakness and dizziness for several hours and hemodynamic collapse. Thoracic echocardiography and computed tomography (CT) showed a large pericardial effusion and aortic intramural hematoma but no evidence of aortic dissection. Therefore, we concluded that the intramural hematoma did not involve the ascending aorta and thus immediately performed pericardiocentesis. Follow-up CT showed no pericardial effusion or specific changes in the range or depth of the intramural hematoma, and she was discharged continuing colchicines and ibuprofen therapy for acute pericarditis. Cardiac tamponade in type B intramural hematoma is extremely rare. Prompt diagnosis and initial treatment resulted in a substantial improvement in clinical status.
Aged ; Aorta ; Cardiac Tamponade* ; Diagnosis ; Dizziness ; Echocardiography ; Emergency Service, Hospital ; Female ; Follow-Up Studies ; Hematoma* ; Hemodynamics ; Humans ; Ibuprofen ; Pericardial Effusion ; Pericardiocentesis ; Pericarditis*