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We report a case of TTS related to pericardiocentesis; an association rarely described in the literature<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient is a 65-year-old male, a former smoker, dyslipidaemic and with a history of bladder tumour in complete remission. He was admitted to Oncology for study and chemotherapy (CT) treatment of a lung mass with multiple lymphadenopathy and anatomical pathology of adenocarcinoma, possibly of gastrointestinal origin, without having identified the primary tumour. Before the start of CT, a transthoracic echocardiogram (TTE) was performed that showed normal left ventricular systolic function (LVEF) and a severe pericardial effusion with echocardiographic data of hemodynamic compromise, without clinical signs of tamponade.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Given these findings, a subxiphoid pericardiocentesis was performed with diagnostic-therapeutic intent, extracting 450 mL of hemorrhagic fluid without immediate complications. A few hours later, the patient developed chest pain and sudden dyspnoea, with hypotension and rapid progression to <span class="elsevierStyleItalic">cardiogenic shock</span>, requiring non-invasive mechanical ventilation, inotropic drugs, and intravenous diuretics. The electrocardiogram showed atrial fibrillation at 120 bpm and a new-onset left bundle branch block, and a severely reduced LVEF due to extensive akinesis of all mid-apical segments, with minimal pericardial effusion on bedside TTE. Given this situation, an emergent coronary angiography was performed, which showed coronary arteries without lesions, and a ventriculography with a pattern compatible with TTS.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Laboratory tests showed lactic acidaemia and a slight elevation of myocardial damage markers (ultrasensitive troponin I 2901 pg/mL).</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patient progressed favourably, and a normal systolic function was observed, with no recurrence of pericardial effusion after 10 days. However, despite cardiological recovery, due to the patient's further general condition deterioration and the delay in the start of CT, secondary to the cardiac complication, it was decided against initiating specific oncological treatment, and he was transferred to a palliative care centre, where he died a few days later.</p><p id="par0030" class="elsevierStylePara elsevierViewall">First, this case raises the differential diagnosis between two entities: pericardial decompression syndrome (PDS) and TTS. PDS has been classically described after pericardiocentesis with drainage of large volumes of fluid, characterized by the occurrence of cardiogenic <span class="elsevierStyleItalic">shock</span> and acute lung oedema with global systolic dysfunction<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. On the other hand, TTS typically manifests as chest pain or heart failure, with transient apical akinesia/dyskinesia in the absence of obstructive coronary artery disease, electrocardiogram changes and mild elevation of myocardial damage markers.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The case reported is highly suggestive of TTS, considering PDS much less likely in the event of a drainage volume lower than 500 mL and the occurrence of segmental contractility abnormalities with a typical mid-apical pattern, rather than global dysfunction, as would be the case in PDS. Likewise, any complication related to pericardiocentesis, such as a ventricular laceration or coronary perforation, was ruled out.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Second, this case highlights the potential poor prognosis of TTS. Although initially attributed with a benign course, there are now several studies showing its association with potentially serious complications in the acute phase, as well as a non-negligible prognostic impact in the medium to long term. Certain predictive factors of an unfavourable course have been reported, such as male sex, physical triggers and a higher initial Killip class<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>, all of them present in this case. Although our patient finally recovered from TTS, its occurrence prevented the initiation of CT and worsened his functional condition, thus causing a clear negative prognostic impact.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0045" class="elsevierStylePara elsevierViewall">This article has not received any type of funding.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interests</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Calaf Vall I, Gayán Ordas J, Fernández-Rodríguez D. Síndrome de Takotsubo post pericardiocentesis. Med Clin (Barc). 2020. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.medcli.2020.05.044">https://doi.org/10.1016/j.medcli.2020.05.044</span></p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Secondary forms of Takotsubo cardiomyopathy: a whole different prognosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I.J. Núñez-Gil" 1 => "M. Almendro-Delia" 2 => "M. Andrés" 3 => "A. Sionis" 4 => "A. Marin" 5 => "T. Bastante" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/2048872615589512" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J Acute Cardiovasc Care" "fecha" => "2016" "volumen" => "5" "paginaInicial" => "308" "paginaFinal" => "316" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26045512" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case report of ventricular dysfunction post pericardiocentesis: stress cardiomyopathy or pericardial decompression syndrome?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Ayoub" 1 => "M. Chang" 2 => "L. Kritharides" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s12947-015-0026-3" "Revista" => array:5 [ "tituloSerie" => "Cardiovasc Ultrasound" "fecha" => "2015" "volumen" => "13" "paginaInicial" => "32" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26179174" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Apicall ballooning syndrome in polymyositis following placement of pericardial drainage catheter" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.J. Liang" 1 => "K.G. Bishu" 2 => "N.S. Anavekar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Cardiovasc Dis" "fecha" => "2014" "volumen" => "2" "paginaInicial" => "174" "paginaFinal" => "176" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Takotsubo cardiomyopathy following pericardiocentesis after aortic valve repair and ascending aorta replacement" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I. Belluschi" 1 => "M. Cioni" 2 => "S. Moriggia" 3 => "O. Alfieri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2016" "volumen" => "102" "paginaInicial" => "291" "paginaFinal" => "293" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary edema after pericardiocentesis for cardiac tamponade" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.H. Vandyke" 1 => "J. Cure" 2 => "C.S. Chakko" 3 => "M. 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