RESUMEN
BACKGROUND: The objective of this study is to review acupuncture-related cardiac complications, such as infective endocarditis (IE), cardiac tamponade (CT), pericarditis, and cardiac rupture, as there is no known reported literature to determine the burden of cardiac adverse events due to acupuncture. METHODS: Structured computerized databases were searched using the special Medical Subject Heading (MeSH). Manual search using the references of relevant articles was also performed. RESULTS: A total of 133 articles were initially retrieved, but careful reading resulted in only 30 cases of relevant cardiac adverse events. There were 8 articles of infective complications (mostly IE), while 22 articles of CT have been reported to date. The diagnoses were made with echocardiography and patients were treated with intravenous antibiotics. The source of the infection was mostly localized to acupuncture needle prick sites, such as earlobes and legs. Mortality rate for post-acupuncture CT was not significantly higher than infective cardiac complication (Pearson's Chi-square = 0.559; likelihood ratio = 0.553). However, the weighted percentage of death was about 80% in CT vs only 20% mortality for infective cardiac complications. On the other hand, CT was the most common presentation when the needle pricks were close to the heart, and had a clinical presentation of hypotension and venous distention. CONCLUSIONS: Although the universally reported complications of acupuncture are low, and the procedure itself has been deemed low risk in acupuncture-related literature, these cardiac complications are alarming. To avoid these potentially catastrophic consequences, more education needs to be done for adopting safer techniques.
Asunto(s)
Terapia por Acupuntura/efectos adversos , Taponamiento Cardíaco , Endocarditis , Rotura Cardíaca , Pericarditis , Terapia por Acupuntura/métodos , Taponamiento Cardíaco/etiología , Taponamiento Cardíaco/prevención & control , Endocarditis/etiología , Endocarditis/prevención & control , Rotura Cardíaca/etiología , Rotura Cardíaca/prevención & control , Humanos , Pericarditis/etiología , Pericarditis/prevención & control , Ajuste de Riesgo , Factores de RiesgoRESUMEN
Left ventricular free-wall rupture (LVFWR) is a serious and lethal complication of acute myocardial infarction. Although this complication is not common, the fatality rate is high due to haemodynamic collapse in the setting of cardiac tamponade. We report a case of LVFWR in a patient with a rare blood group, who survived because of an innovative technique for pericardiocentesis and simultaneous transfusion of the aspirated blood into the femoral sheath. A video of the patient's ventriculography is provided.