Cardiac Tamponade Caused by Upper Abdominal Acupuncture in a Patient with Chronic Obstructive Pulmonary Disease
10.18525/cu.2025.10.2.109
- Author:
Bogyeong KIM
1
;
Kang-Un CHOI
Author Information
1. College of Medicine, Yeungnam University, Daegu, Korea
- Publication Type:Case Report
- From:
Clinical Ultrasound
2025;10(2):109-113
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 69-year-old man presented to the emergency department with acute chest pain several hours after abdominal acupuncture for dyspepsia, performed at a clinic of Traditional Korean Medicine. Chest radiography revealed emphysematous lung changes without definite cardiomegaly, as the pericardial effusion was predominantly located in the inferior pericardial space. Chest computed tomography revealed a pericardial effusion adjacent to the right ventricular free wall. Transthoracic echocardiography demonstrated a large pericardial effusion (2.2 cm) with early diastolic right ventricular collapse, plethoric inferior vena cava, consistent with tamponade physiology. Emergency pericardiocentesis via the subcostal approach drained dark, thick sanguineous fluid, suggesting pericardial hemorrhage. Laboratory analysis of the pericardial fluid revealed a markedly hemorrhagic, non-infectious effusion (red blood cell count 1.6 × 106/μL, ADA 19.0 U/L, and negative AFB staining and culture). A pericardial catheter was placed, and the total drainage volume was 507 mL over 4 days. The patient recovered without recurrence after catheter removal. This case highlights acupuncture-induced traumatic hemopericardium as a rare but potentially fatal complication. It also underscores the importance of echocardiographic evaluation and detailed history taking, particularly when acupuncture is performed in the epigastric (subxiphoid) region.
