A case of hemorrhagic pleural effusion postprimary PCI—rare event of postcardiac injury syndrome

Abstract

Background

Postcardiac injury syndrome (PCIS) includes pleuropericardial inflammation and effusion syndromes after traumatic mesothelial cell injury to the pericardium or pleural cavity. Several triggers have been identified, that can cause PCIS including percutaneous coronary intervention (PCI), cardiac implantable electronic device (CIED) implantation, and cardiac surgical procedures. Though most common form occurs postcardiac surgeries, there are reports of PCIS occurring after PCI.

Case summary

We present one such rare event of right-sided pleural effusion occurring after primary PCI, diagnosed based on ESC guidelines on PCIS, after exclusion of other possible causes.

Discussion

PCIS is a diagnosis of exclusion, typically presenting as new onset pericardial effusion. Although rare, pleural effusion can occur as a part of PCIS with reports of both left- and right-sided pleural effusion. Management being conservative seems relatively simpler, but given the possibility of recurrence, long-term follow up becomes important, which necessitates making the diagnosis of PCIS, though rare. This case is one of the rare events occurring during a commonly performed procedure worldwide. PCIS in diagnosis of unexplained pleural/pericardial effusion occurring after PCI should always be considered. This may be an insight for taking into account, such uncommon events after a common intervention.

Graphical abstract

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