haemopericardium

Introduction

hemopericardium is blood within the pericardial sac
death is generally more likely to be caused by the cause of the haemopericardium rather than by the effects of the haemopericardium although if it collects rapidly it may of itself cause death through cardiac tamponade and may present as persistent sinus tachycardia, dizziness, syncope / near syncope or sudden death.

ruptured ventricular wall (~60% of non-traumatic causes)
- full thickness necrosis of cardiac wall due to acute myocardial infarction (AMI/STEMI/NSTEMI)
- ruptured left ventricular aneurysm
Type A aortic dissection accounts for ~30% of non-traumatic causes
- ascending aorta intramural haematoma may cause acute aortic regurgitation, haemopericardium (via retrograde bleeding into the sac), aortic rupture or AMI
- the haemopericardium may be caused by a penetrating atherosclerotic ulcer in the aortic root presenting as syncope with cardiac tamponade ¹⁾
ruptured aneurysms of the aortic arch
ruptured aneurysm of sinus of Valsalva
ruptured coronary artery aneurysm
pericarditis
anticoagulation
thrombolysis
leukaemia
initial manifestation of essential thrombocytosis ²⁾
neoplasia / cancer / tumours eg sarcoma of the heart ³⁾

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