pneumopericardium - air in the pericardium - pnömoperikardiyum - perikard içinde hava - ekg - ecg - ankara kardiyoloji - kalp hastalıkları - mete alpaslan

Pneumopericardium and the ECG

Last update: April 2020

Pneumopericardium is a rare disease. It is defined as the presence of air or gas in the pericardial sac.

Causes of pneumopericardium

Gas-producing infections of the pericardium.

Blunt or penetrating chest trauma.

Fistulous connection between the esophagus and pericardial cavity (due to lymphoma or infection).

Fistulous connection between the trachea and pericardial cavity (due to lymphoma).

As a complication after gastric or esophageal surgery.

Inhalation of 1-1-difluoroethane (may also cause cardiomyopathy or myocarditis).

Pericardial-esophageal fistula as a complication of radiofrequency ablation for atrial fibrillation.

Fistula between the pericardium and colon, presenting with pericarditis.

Face-mask continuous positive airway pressure (CPAP)

ECG changes observed during pneumopericardium

Low voltage. It has been suggested that even if frank low voltage is not evident, observation of relatively low voltage in every lead (when compared with preoperative ECGs) may prompt a search for pneumopericardium in selected postoperative patients.

Diffuse ST segment elevation with PR depression (compatible with pericarditis)

ST segment elevation alone (mimicking myocardial infarction). ST segment elevation may disappear after treatment of pneumopericardium.

ST segment depression

Right axis deviation (may disappear after treatment of pneumopericardium).

Incomplete right bundle branch block

Prolonged QT interval

ECG may be normal in some patients with pneumopericardium.

References

Cureus 2018;10(10):e3503 (free full-text)

Pacing Clin Electrophysiol 2018;41:331-333.

Int J Cardiol 2016;203:1-2.

Heart 2014;100:1300.

BMJ Case Rep 2015;2015. pii: bcr2014206108 (free full-text)

BMC Res Notes 2015;8:173. (free full-text)