Successful Management of Massive Hemopericardium Secondary to Uremic Pericarditis: A Case Report

Uremic pericarditis is a major complication of acute or chronic end-stage renal disease (ESRD). A significant cause of morbidity and mortality in most hemodialysis programs, uremic pericarditis can occur before dialysis or on dialysis. The causes of uremic and dialysis pericarditis remain uncertain. Accurate hemodialysis and pericardiocentesis result in marked improvements. The diagnosis of uremic pericarditis, in addition to other causes such as idiopathic, malignant, coagulopathy, and tuberculous pericarditis, should, therefore, be considered in the differential diagnosis for cases presenting with hemorrhagic pericardial effusion. Here, we describe a 50-year-old man, who presented with shortness of breath and altered levels of consciousness of 5 days’ duration with a history of hypertension, diabetes, and ESRD on hemodialysis over the past 5 years. The patient was admitted to our hospital with a diagnosis of acute massive hemopericardium secondary to uremic pericarditis after staining and cytology detected an exudate pericardial effusion despite no evidence of infection (eg, tuberculosis) or malignancy. He was admitted into the intensive care unit and successfully managed with hemodialysis and pericardiocentesis.