An interesting case at Manmohan cardiac centre dealt by Dr. Om Murti Anil

55 yr man with diabetic background, had 1 month h/o dyspnoea. Echo showed pericardial tamponade. About 200ml altered colour blood was removed by pericardiocentesis. ECG showed Q wave in inferior leads s/o old inferior wall MI.After 4days he again had tamponade. There was no fluid in subcostal echo view this time and hence pericardiocentesis

 through epigastrium was not possible.. Pericardiocentesis through apical approach was then performed and 1200 ml altered blood was removed through pigtail (Fig). Detailed echo after drainage revealed large true aneurysm of inferior wall which has ruptured and sealed sponataneously by clot. This was a rare case of cardiac rupture after MI where patient survived even after development of cardiac tamponade.

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