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## Cardiac tamponade A 43-year-old man experienced cardiac tamponade during treatment with methotrexate for rheumatoid arthritis (RA). The man, whose medical history was significant for recurrent deep vein thromboses and seropositive RA, presented to hospital with an aggravating central pleuritic chest pain, accompanied by tachypnoea and fevers for 4 weeks. It was reported that four weeks earlier, he started receiving methotrexate [route and dosage not stated] for RA. However, methotrexate was subsequently discontinued due to concerns about the medication being responsible for the man's chest pain. On examination, he appeared clammy and grey. He had tachycardia and tachpynoea. Blood gas analysis revealed type-1 respiratory failure. ECG showed sinus tachycardia, while chest X-ray revealed an enlarged heart, as well as left sided pulmonary consolidation. Initial bedside echocardiography revealed a moderate pericardial effusion; however, no evidence of compromise was detected. His BP improved after a single fluid bolus. He was initially diagnosed with chest sepsis, after which he was referred to critical care for respiratory support. However, subsequent CT scan of his chest revealed e

Who reads Methotrexate: Cardiac tamponade?

Publisher

Springer Science and Business Media LLC

Published

2021

Language

EN

Field

Medicine (Health Sciences)