ABSTRACT
IMPORTANCE: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the postresuscitation period, and we do not know current post-IHCA practice patterns. To address this gap, we developed the Discover IHCA study, which will thoroughly evaluate current post-IHCA care practices across a diverse cohort. OBJECTIVES: Our study collects granular data on post-IHCA treatment practices, focusing on temperature control and prognostication, with the objective of describing variation in current post-IHCA practices. DESIGN, SETTING, AND PARTICIPANTS: This is a multicenter, prospectively collected, observational cohort study of patients who have suffered IHCA and have been successfully resuscitated (achieved ROSC). There are 24 enrolling hospital systems (23 in the United States) with 69 individuals enrolling in hospitals (39 in the United States). We developed a standardized data dictionary, and data collection began in October 2023, with a projected 1000 total enrollments. Discover IHCA is endorsed by the Society of Critical Care Medicine. MAIN OUTCOMES AND MEASURES: The study collects data on patient characteristics, including prearrest frailty, arrest characteristics, and detailed information on postarrest practices and outcomes. Data collection on post-IHCA practice was structured around current American Heart Association and European Resuscitation Council guidelines. Among other data elements, the study captures postarrest temperature control interventions and postarrest prognostication methods. RESULTS: The majority of participating hospital systems are large, academic, tertiary care centers serving urban populations. The analysis will evaluate variations in practice and their association with mortality and neurologic function. CONCLUSIONS AND RELEVANCE: We expect this study, Discover IHCA, to identify variability in practice and outcomes following IHCA and be a vital resource for future investigations into best practices for managing patients after IHCA.
Subject(s)
Cardiopulmonary Resuscitation , Chest Tubes , Heart Arrest , Pericardiocentesis , Thoracostomy , Humans , Heart Arrest/therapy , Heart Arrest/mortality , Male , Female , Retrospective Studies , Aged , Middle Aged , Thoracostomy/methods , Thoracostomy/instrumentation , Cardiopulmonary Resuscitation/methods , Cohort Studies , Adult , United States/epidemiologySubject(s)
Atrial Fibrillation , Chest Pain , Methicillin-Resistant Staphylococcus aureus , Pericarditis , Staphylococcal Infections , Substance Abuse, Intravenous , Aged , Humans , Male , Acute Disease , Anti-Bacterial Agents/therapeutic use , Atrial Fibrillation/diagnosis , Atrial Fibrillation/etiology , Atrial Fibrillation/therapy , Chest Pain/etiology , Chest Pain/therapy , Diagnosis, Differential , Echocardiography , Electrocardiography , Fentanyl , Narcotic-Related Disorders/complications , Pericardial Fluid/microbiology , Pericardiocentesis , Pericarditis/diagnosis , Pericarditis/microbiology , Pericarditis/therapy , Pericarditis, Constrictive , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcal Infections/therapy , Substance Abuse, Intravenous/complications , Suppuration/microbiology , Suppuration/therapy , Ill-Housed Persons , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/drug therapy , HIV Infections/complications , HIV Infections/drug therapyABSTRACT
Point-of-care ultrasound (POCUS) has been shown to be a valuable tool in the management of acutely ill patients in the prehospital setting. POCUS not only has utility from a diagnostic perspective but also has been shown to reduce the rate of complications from otherwise traditionally "blind" procedures, such as pericardiocentesis. This case report highlights the utility of POCUS in the prehospital setting to guide emergent pericardiocentesis to treat cardiac tamponade. The applicability of various approaches to ultrasound-guided pericardiocentesis is also discussed.
Subject(s)
Cardiac Tamponade , Emergency Medical Services , Pericardiocentesis , Point-of-Care Systems , Humans , Pericardiocentesis/methods , Emergency Medical Services/methods , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/surgery , Cardiac Tamponade/therapy , Male , Ultrasonography, Interventional/methods , Ultrasonography/methods , Middle Aged , Pericardial Effusion/diagnostic imaging , Pericardial Effusion/surgery , Pericardial Effusion/therapyABSTRACT
An 11-year-old female spayed German Wirehaired Pointer with a 1-week history of lethargy, hyporexia, diarrhea, and coughing presented with pericardial effusion causing cardiac tamponade. An echocardiogram revealed no structural cause for pericardial effusion. The pericardial effusion was an exudate with mixed macrophagic and neutrophilic inflammation. Morulae occasionally were found within neutrophils. The pericardial fluid and blood were qPCR and cPCR positive for Anaplasma phagocytophilum (NC State University, Vector-borne Disease Diagnostic Laboratory, Raleigh, NC). The dog's blood was negative by ELISA (Vetscan Flex4 Rapid Test, Zoetis, Parsippany, NJ) for A. phagocytophilum antibodies at initial presentation and subsequently positive (SNAP4DxPlus, IDEXX, Westbrook, ME) 7 days later. After pericardiocentesis and administration of doxycycline (5 mg/kg PO q12h for 14 days), a repeat echocardiogram performed 1 month later showed no recurrence of pericardial effusion.
Subject(s)
Anaplasma phagocytophilum , Dog Diseases , Doxycycline , Ehrlichiosis , Pericardial Effusion , Animals , Female , Pericardial Effusion/veterinary , Pericardial Effusion/microbiology , Dog Diseases/diagnosis , Dog Diseases/microbiology , Anaplasma phagocytophilum/isolation & purification , Dogs , Ehrlichiosis/veterinary , Ehrlichiosis/complications , Ehrlichiosis/diagnosis , Doxycycline/therapeutic use , Anti-Bacterial Agents/therapeutic use , Echocardiography/veterinary , Pericardiocentesis/veterinaryABSTRACT
INTRODUCTION: Purulent pericarditis secondary to esophago-pericardial fistula is a serious complication that has been previously reported in patients with esophageal cancer treated with radio/chemotherapy and esophageal stenting. However, the presence of esophago-pericardial fistula as the first manifestation of advanced carcinoma of the esophagus is exceedingly infrequent. We report the case of a 61-year-old male who presented with sepsis, cardiac tamponade and septic shock who was found to have an esophago-pericardial fistula secondary to squamous carcinoma of the esophagus. Emergency pericardiocentesis was performed with subsequent hemodynamic improvement. The drained pericardial fluid was purulent in nature and cultures were positive for Streptococcus anginosus. A CT scan followed by upper gastrointestinal endoscopy with tissue biopsy confirmed the diagnosis of squamous cell carcinoma of the esophagus. A self-expanding covered stent was endoscopically placed to exclude the fistula and restore the esophageal lumen. In this report, we discuss some aspects related to the diagnosis and management of this serious clinical entity.
Subject(s)
Carcinoma, Squamous Cell , Esophageal Fistula , Esophageal Neoplasms , Pericarditis , Humans , Male , Middle Aged , Esophageal Neoplasms/pathology , Esophageal Neoplasms/complications , Pericarditis/microbiology , Pericarditis/etiology , Pericarditis/therapy , Pericarditis/diagnosis , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/complications , Carcinoma, Squamous Cell/diagnosis , Esophageal Fistula/etiology , Esophageal Fistula/diagnosis , Streptococcal Infections/complications , Streptococcal Infections/diagnosis , Streptococcus anginosus/isolation & purification , Pericardiocentesis , Stents , Tomography, X-Ray Computed , Cardiac Tamponade/etiologyABSTRACT
Fetal pericardial teratomas are rare. They present with pericardial effusion and hydrops. The definitive management is postnatal resection of the tumor. The exact antenatal management is not known due to its rarity. We present a case of fetal pericardial teratoma with pericardial tamponade. Pericardiocentesis performed at 31 weeks significantly relieved the venous compression, leading to resolution of hydrops and prolonging the gestational age for the definitive management.
Subject(s)
Heart Neoplasms , Pericardiocentesis , Teratoma , Humans , Teratoma/surgery , Teratoma/complications , Teratoma/diagnosis , Teratoma/diagnostic imaging , Pericardiocentesis/methods , Female , Heart Neoplasms/complications , Heart Neoplasms/surgery , Heart Neoplasms/diagnostic imaging , Heart Neoplasms/diagnosis , Pregnancy , Adult , Ultrasonography, Prenatal , Pericardial Effusion/surgery , Pericardial Effusion/diagnostic imaging , Pericardial Effusion/etiology , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Cardiac Tamponade/diagnosis , Hydrops Fetalis/etiology , Hydrops Fetalis/diagnosis , Hydrops Fetalis/surgery , Fetal Diseases/surgeryABSTRACT
Pericarditis is a well-known complication of hypothyroidism. Although pericarditis and pericardial effusions have been reported as rare complications of hyperthyroidism in adults, they are rarely reported in the pediatric population. In this case report, we describe a 12-year-old, previously healthy girl with nighttime chest pain, dyspnea, tachycardia, and abnormal thyroid function studies consistent with hyperthyroidism who was found to have pericarditis and pericardial effusion requiring pericardiocentesis.
Subject(s)
Graves Disease , Pericardial Effusion , Humans , Pericardial Effusion/etiology , Pericardial Effusion/diagnostic imaging , Female , Graves Disease/complications , Graves Disease/diagnosis , Child , Pericardiocentesis , Pericarditis/etiology , Pericarditis/diagnosis , Pericarditis/complicationsABSTRACT
Pericardiocentesis is an important diagnostic and therapeutic procedure. In the setting of cardiac tamponade, pericardiocentesis can rapidly improve hemodynamics, and in cases of diagnostic uncertainty, pericardiocentesis allows for fluid analysis to aid in diagnosis. In contemporary practice, the widespread availability of ultrasonography has made echocardiographic guidance the standard of care. Additional tools such as micropuncture technique, live ultrasonographic guidance, and adjunctive tools including fluoroscopy continue to advance and enhance procedural efficiency and safety. When performed by experienced operators, pericardiocentesis is a safe, effective, and potentially life-saving procedure.
Subject(s)
Cardiac Tamponade , Pericardial Effusion , Humans , Pericardiocentesis/methods , Cardiac Tamponade/surgery , Pericardial Effusion/diagnosis , Echocardiography/methodsABSTRACT
AIMS: Pericardiocentesis is usually completed under fluoroscopy. The electroanatomic mapping (EAM) system allows visualizing puncture needle tip (NT) while displaying the electrogram recorded from NT, making it possible to obtain epicardial access (EA) independent of fluoroscopy. This study was designed to establish and validate a technique by which EA is obtained under guidance of three-dimensional (3D) EAM combined with NT electrogram. METHODS AND RESULTS: 3D shell of the heart was generated, and the NT was made trackable in the EAM system. Unipolar NT electrogram was continuously monitored. Penetration into pericardial sac was determined by an increase in NT potential amplitude and an injury current. A long guidewire of which the tip was also visible in the EAM system was advanced to confirm EA. Epicardial access was successfully obtained without complication in 13 pigs and 22 patients. In the animals, NT potential amplitude was 3.2 ± 1.0â mV when it was located in mediastinum, 5.2 ± 1.6â mV when in contact with fibrous pericardium, and 9.8 ± 2.8â mV after penetrating into pericardial sac (all P ≤ 0.001). In human subjects, it measured 1.54 ± 0.40â mV, 3.61 ± 1.08â mV, and 7.15 ± 2.88â mV, respectively (all P < 0.001). Fluoroscopy time decreased in every 4-5 cases (64 ± 15, 23 ± 17, and 0â s for animals 1-4, 5-8, 9-13, respectively, P = 0.01; 44 ± 23, 31 ± 18, 4±7â s for patients 1-7, 8-14, 15-22, respectively, P < 0.001). In five pigs and seven patients, EA was obtained without X-ray exposure. CONCLUSION: By tracking NT in the 3D EAM system and continuously monitoring the NT electrogram, it is feasible and safe to obtain EA with minimum or no fluoroscopic guidance.
Subject(s)
Electrophysiologic Techniques, Cardiac , Epicardial Mapping , Imaging, Three-Dimensional , Needles , Pericardium , Humans , Male , Female , Animals , Pericardium/diagnostic imaging , Pericardium/surgery , Middle Aged , Imaging, Three-Dimensional/methods , Aged , Electrophysiologic Techniques, Cardiac/instrumentation , Electrophysiologic Techniques, Cardiac/methods , Epicardial Mapping/methods , Pericardiocentesis/methods , Punctures , Predictive Value of Tests , Adult , Swine , Models, Animal , Action Potentials , Sus scrofa , FluoroscopyABSTRACT
A 55-year-old male with acute pericarditis presented with low-pressure cardiac tamponade (LPCT) unresponsive to volume infusion. Subsequent pericardiocentesis resulted in hemodynamic improvement and unmasking of pericardial constriction. This case provides illustrative hemodynamic tracings of LPCT. Additionally, the presence of concurrent pericardial constriction that may indicate a plausible underlying mechanism for the blunted responsiveness to fluid expansion in LPCT. The underlying physiologic processes and the associated hemodynamic tracings are discussed.
Subject(s)
Cardiac Tamponade , Hemodynamics , Pericardiocentesis , Humans , Cardiac Tamponade/physiopathology , Cardiac Tamponade/etiology , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/surgery , Male , Middle Aged , Treatment Outcome , Pericarditis/physiopathology , Pericarditis/therapy , Pericarditis/diagnostic imaging , Pericarditis/etiology , Pericarditis/diagnosis , Acute DiseaseABSTRACT
Periodontal diseases are well-known background for infective endocarditis. Here, we show that pericardial effusion or pericarditis might have origin also in periodontal diseases. An 86-year-old man with well-controlled hypertension and diabetes mellitus developed asymptomatic increase in pericardial effusion. Two weeks previously, he took oral new quinolone antibiotics for a week because he had painful periodontitis along a dental bridge in the mandibular teeth on the right side and presented cheek swelling. The sputum was positive for Streptococcus species. He was healthy and had a small volume of pericardial effusion for the previous 5 years after drug-eluting coronary stents were inserted at the left anterior descending branch 10 years previously. The differential diagnoses listed for pericardial effusion were infection including tuberculosis, autoimmune diseases, and metastatic malignancy. Thoracic to pelvic computed tomographic scan demonstrated no mass lesions, except for pericardial effusion and a small volume of pleural effusion on the left side. Fluorodeoxyglucose positron emission tomography disclosed many spotty uptakes in the pericardial effusion. The patient denied pericardiocentesis, based on his evaluation of the risk of the procedure. He was thus discharged in several days and followed at outpatient clinic. He underwent dental treatment and pericardial effusion resolved completely in a month. He was healthy in 6 years until the last follow-up at the age of 92 years. We also reviewed 8 patients with pericarditis in association with periodontal diseases in the literature to reveal that periodontal diseases would be the background for developing infective pericarditis and also mediastinitis on some occasions.
Subject(s)
Pericardial Effusion , Pericarditis , Periodontal Diseases , Periodontitis , Male , Humans , Aged, 80 and over , Pericardial Effusion/complications , Pericardial Effusion/diagnosis , Pericardiocentesis/adverse effects , Pericardiocentesis/methods , Pericarditis/complications , Periodontitis/complications , Periodontal Diseases/complicationsSubject(s)
Balloon Occlusion , Cardiac Tamponade , Pericardial Effusion , Humans , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/etiology , Cardiac Tamponade/surgery , Pericardiectomy , Treatment Outcome , Pericardial Effusion/diagnostic imaging , Pericardial Effusion/etiology , Pericardial Effusion/surgery , PericardiocentesisABSTRACT
Misplacement of pericardiocentesis catheter in central veins is a rare complication that can be managed with several methods. In this case, we report a percutaneous image-guided plug-assisted management of a misplaced pericardiocentesis catheter into the inferior vena cava through a transhepatic tract successfully occluded. This minimally invasive technique was not previously described in this setting and had a favorable long-term outcome.
Clinical case of a minimally invasive technique guided by imaging to fix a complication of a misplaced drainage catheter for pericardial hemorrhageThis clinical case reports how to manage, using a minimally invasive technique guided by imaging, an accidental puncture of the liver and the inferior vena cava during a pericardial hemorrhage drainage. The outcome was good, with technical success and a favorable outcome for the patient.
Subject(s)
Pericardiocentesis , Vena Cava, Inferior , Humans , Vena Cava, Inferior/diagnostic imaging , Pericardiocentesis/adverse effects , Veins , CathetersABSTRACT
Peripherally inserted central catheter (PICC) insertion is a routine procedure in the neonatal intensive care unit required for prolonged intravenous fluid, nutrition and medication support. Neonatal cardiac tamponade is a serious and rare complication of PICC line insertion. Early detection by point of care ultrasound (POCUS) and management by pericardiocentesis improves the chances of survival. Regular simulation-based training sessions on a mannequin, along with knowledge of POCUS, can assist neonatologists and paediatricians for a quick and appropriate response in this emergency condition.
Subject(s)
Cardiac Tamponade , Catheterization, Central Venous , Humans , Infant, Newborn , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/etiology , Cardiac Tamponade/therapy , Catheterization, Central Venous/adverse effects , Catheterization, Central Venous/methods , Pericardiocentesis , Point-of-Care Systems , UltrasonographyABSTRACT
OBJECTIVES: Malignant pericardial effusion (MPE) in patients with cancer is associated with poor prognosis. This study aimed to compare clinical outcomes in patients with cancer who underwent pericardiocentesis versus pericardial window formation. METHODS: In the present study, 765 consecutive patients with cancer (mean age 58.4 years, 395 men) who underwent pericardial drainage between 2003 and 2022 were retrospectively analysed. All-cause death and MPE recurrence were compared based on the drainage method (pericardiocentesis vs pericardial window formation) and time period (period 1: 2003-2012; period 2: 2013-2022). RESULTS: Pericardiocentesis was performed in 639 (83.5%) patients and pericardial window formation in 126 (16.5%). There was no difference in age, sex distribution, proportion of metastatic or relapsed cancer, and chemotherapy status between the pericardiocentesis and pericardial window formation groups. Difference was not found in all-cause death between the two groups (log-rank p=0.226) regardless of the period. The pericardial window formation group was associated with lower MPE recurrence than the pericardiocentesis group (6.3% vs 18.0%, log-rank p=0.001). This advantage of pericardial window formation was more significant in period 2 (18.1% vs 1.3%, log-rank p=0.005). In multivariate analysis, pericardial window formation was associated with lower MPE recurrence (HR: 0.31, 95% CI: 0.15 to 0.63, p=0.001); younger age, metastatic or relapsed cancer, and positive malignant cells in pericardial fluid were associated with increased recurrence. CONCLUSION: In patients undergoing pericardial drainage for MPE, pericardial window formation showed mortality outcomes comparable with pericardiocentesis and was associated with lower incidence of MPE recurrence.
Subject(s)
Neoplasms , Pericardial Effusion , Pericardial Window Techniques , Pericardiocentesis , Humans , Pericardiocentesis/methods , Male , Female , Middle Aged , Retrospective Studies , Pericardial Effusion/etiology , Pericardial Effusion/therapy , Pericardial Effusion/epidemiology , Neoplasms/complications , Aged , Treatment Outcome , Recurrence , Drainage/methods , Time Factors , Risk FactorsABSTRACT
BACKGROUND: Previous case studies have reported reversal of acute renal failure after pericardiocentesis in pericardial effusion. This study examines the effects of pericardiocentesis on preprocedural low cardiac output and acute renal dysfunction in patients with pericardial effusion. METHODS: This is a retrospective study of 95 patients undergoing pericardiocentesis between 2015 and 2020. Pre- and post-procedure transthoracic echocardiograms (TTE) were reviewed for evidence of cardiac tamponade, resolution of pericardial effusion, and for estimation of right atrial (RA) pressure and cardiac output. Laboratory values were compared at presentation and post-procedure. Patients on active renal replacement therapy were excluded. RESULTS: Ninety-five patients were included for analysis (mean age 62.2 ± 17.8 years, 58% male). There was a significant increase in glomerular filtration rate pre- and post-procedure. Fifty-six patients (58.9%) had an improvement in glomerular filtration rate after pericardiocentesis (termed "responders"), and these patients had a lower pre-procedure glomerular filtration rate than "non-responders." There was a significant improvement in estimated cardiac output and right atrial pressure for patients in both groups. Patients who had an improvement in renal function had significantly lower pre-procedural diastolic blood pressure and mean arterial pressure. CONCLUSIONS: Pericardial drainage may improve effusion-mediated acute renal dysfunction by reducing right atrial pressure and thus systemic venous congestion, and by increasing forward stroke volume and perfusion pressure.
Subject(s)
Cardiac Tamponade , Kidney Diseases , Pericardial Effusion , Humans , Male , Adult , Middle Aged , Aged , Aged, 80 and over , Female , Pericardiocentesis , Pericardial Effusion/diagnostic imaging , Pericardial Effusion/surgery , Retrospective Studies , Cardiac Tamponade/surgery , Hemodynamics , Kidney/diagnostic imagingABSTRACT
We present the case of a premature neonate with pericardial effusion secondary to extravasation of total parenteral nutrition from a mispositioned/migrated umbilical venous catheter. Emergency pericardiocentesis was complicated by an intrapericardial thrombus, which was managed conservatively with spontaneous resolution within 24 hours. This case illustrates that the rare complication of an intrapericardial thrombus after pericardiocentesis can be successfully managed conservatively with close monitoring in haemodynamically stable paediatric patients.
Subject(s)
Cardiac Tamponade , Pericardial Effusion , Thrombosis , Humans , Infant, Newborn , Cardiac Tamponade/diagnosis , Cardiac Tamponade/etiology , Pericardial Effusion/diagnosis , Pericardial Effusion/etiology , Pericardiocentesis/adverse effects , Thrombosis/etiology , Thrombosis/complicationsABSTRACT
INTRODUCTION: The management of even large pericardial effusions in asymptomatic patients is still a matter of debate. Aim of the present study is to explore, in a multicenter setting, the rate of post-cardiac injury syndromes (PCIS) and pericardial effusion recurrence after pericardial effusion drainage procedure. MATERIAL AND METHODS: This is a multicenter international retrospective study including a consecutive cohort of patients diagnosed with large, chronic and idiopathic pericardial effusions, prospectively evaluated from January 2003 to December 2021 who underwent a clinically indicated pericardial drainage procedure. Two separate end-points were recorded: 1) recurrence of pericardial effusion after drainage without any sign of pericardial inflammation 2) occurrence of PCIS, defined as the new onset of pericarditis 1 to 6 weeks after pericardial intervention. RESULTS: 124 patients were enrolled (50 % female, mean age 64 years old). A mean follow-up of 29.6 ± 25.6 months was obtained in 110 patients (88 %). 110 patients were treated with pericardiocentesis (89 %), 25 with pleuro-pericardial windows (20 %), and 1 with pericardiectomy (1 %). PCIS occurred in 21 out of 124 patients followed for at least 6 weeks (16.9%). Recurrence of pericardial effusion after drainage without any sign of pericardial inflammation occurred in 68 out of 110 patients at a longer follow-up (61.8 %). At multivariate analysis only inflammatory cells in pericardial fluid was associated with PCIS and pericardiocentesis with pericardial effusion recurrency. CONCLUSION: Our data support the need of caution with the use of pericardiocentesis in asymptomatic patients with large pericardial effusion as it is often associated with pericardial effusion recurrence. Of interest the presence of inflammatory cells in the pericardial fluid is associated with PCIS after pericardial drainage procedures.
Subject(s)
Drainage , Pericardial Effusion , Pericardiocentesis , Recurrence , Humans , Pericardial Effusion/etiology , Female , Male , Middle Aged , Retrospective Studies , Aged , Pericarditis/etiology , Pericardial Window Techniques , Pericardiectomy , Heart Injuries/complicationsABSTRACT
A 58-year-old male patient presented with anterior myocardial infarction after 36 hours of symptom onset.
Subject(s)
Anterior Wall Myocardial Infarction , Pericardiocentesis , Male , Humans , Middle Aged , Pericardiocentesis/adverse effects , Hepatic ArteryABSTRACT
Pericardiocentesis (PC) in patients with pulmonary hypertension (PH) and pericardial effusions has unclear benefits because it has been associated with acute hemodynamic collapse and increased mortality. Data on in-hospital outcomes in this population are limited. The National Inpatient Sample database was used to identify adult patients who underwent PC during hospitalizations between 2016 and 2020. Data were stratified by the presence or absence of PH. A multivariate regression model and case-control matching was used to estimate the association of PH with PC in-hospital outcomes. A total of 95,665 adults with a procedure diagnosis of PC were included, of whom 7,770 had PH. Patients with PH tended to be older (aged 67 ± 15.7 years) and female (56%) and less frequently presented with tamponade (44.9% vs 52.4%). Patients with PH had significantly higher rates of chronic kidney disease, coronary artery disease, heart failure, and chronic lung disease, among other co-morbidities. In the multivariate analysis, PC in PH was associated with higher all-cause mortality (adjusted odds ratio [aOR] 1.40, confidence interval [CI] 1.30 to 1.51) and higher rates of postprocedure shock (aOR 1.53, CI 1.30 to 1.81) than patients without PH. Mortality was higher in those with pulmonary arterial hypertension than other nonpulmonary arterial hypertension PH groups (aOR 2.35, 95% CI 1.46 to 3.80, p <0.001). The rates of cardiogenic shock (aOR 1.49, 95% CI 1.38 to 1.61), acute respiratory failure (aOR 1.56, 95% CI 1.48 to 1.64), and mechanical circulatory support use (aOR 1.86, 95% CI 1.63 to 2.12) were also higher in patients with PH. There was no significant volume-outcome relation between hospitals with a high per-annum pericardiocentesis volume compared with low-volume hospitals in these patients. In conclusion, PC is associated with increased in-hospital mortality and higher rates of cardiovascular complications in patients with PH, regardless of the World Health Organization PH group.