Interdisciplinary Case Submission Example 1

Title: Title that highlights topic focus.
E.g. Cardiac Tamponade as a Complication of Non-Cardiac Conditions

Author Block: Author(s) and affiliated institutions.
E.g. James Black, Sarah Smith, Jeff Lentz, David Beck, Howard University Hospital, Anywhere, USA.

Background: Describe the background of the clinical problem, clinical case or practice innovation.
E.g. Cardiac tamponade is a complication of large pericardial effusion, often requiring urgent or emergent intervention such as percutaneous or surgical drainage. Pericardial effusions causing tamponade secondary to underlying conditions may require multisystem evaluation and treatments.

Case Description: Describe the clinical case and a brief overview of the initial presentation including exam findings, or specifics on clinical problem or innovation.
E.g. A 64 year-old male presented with right shoulder pain persisting for two days. Past medical history included chronic pancreatitis, and abdominal distention. Physical examination findings were consistent with pulsus paradoxus, hypotension, tachycardia, jugular venous distension, and distant heart sounds. Pulmonary exam revealed diminished bibasilar breath sounds.

Decision-making: Describe your role/team role in the case/innovation/practice model.
E.g. An ECG demonstrated sinus tachycardia with low QRS voltage. Bedside echocardiography demonstrated right ventricular collapse in early diastole and a large, pericardial effusion. CT Chest demonstrated a large pancreatic pseudocyst extending into the mediastinum and abutting the pericardium. Given the concern for recurrence of pericardial effusion in the setting of a pseudocyst extending into the thoracic space, Cardiothoracic Surgery was consulted for open surgical drainage with pericardiectomy. Following the pericardial window, interventional radiology team was consulted and following collaboration with cardiology proceeded with pseudocyst drainage. The etiology of her pericardial effusion was likely chemical pericarditis secondary to pancreatic enzymes. GI continued to follow throughout the postoperative course. The patient recovered without further recurrence of pericardioa effusion.

Conclusion: Important teaching point, take home pearl, or practice innovation.
E.g. This case demonstrates the importance of recognizing cardiac tamponade, establishing its etiology and providing definitive therapy to prevent recurrence of pericardial effusion.

References/Resources: More information for the learner.
E.g. Available literature or resources that can assist the learner.