Abstract
Two cases of massive pericardial effusion due to uremis pericarditis during maintenance hemodialysis (HD) are reported. Case 1: A 61-year-old man on maintenance HD for years admitted because of chest pain and dyspnea. Serum examinations and echocardiography revealed prominent inflammatory signs and moderate pericardial effusion, Intensive HD relieved the subjective complaints. However pericardial effusion progressively increased and right ventricular diastolic collapse was detected by echocardiography. Sudden cardiac arrest occurred on the 6th hospital day and died.
Case 2: A 66-year-old woman on maintenance HD for months was admitted because of deep coma, respiratory arrest and cardiogenic shock. Pulmonary congestion, massive pericardial effusion and enhanced inflammatory signs were found by laboratory examination. She recovered after cardiopulmonary resuscitation and emarenc HD. However, pericardial effusion did not decrease and congestive heart failure persisted on the 16th hospital day. lntenswe HD combined with hemofiltration was performed, although her pericardial effusion did not improve. Finally, ericaricentesis and drainage were needed to reduce the effusion and no recurrencewas observed.
Pericarditis is one of the fatal complications in patients with end-stage renal failure and/or on maintenance HD. Diastolic right-sided chamber collapse detected by echocardiography is suggested to be an important sign for pericriocentesis.
