Hiccups as the Presenting Manifestation of Cardiac Tamponade: A Case Report

Jiashan Chen; Jen-Tang Sun; Chieh-Min Fan; Kuang-Chau Tsai; Chih-Jung Chang

doi:10.1016/j.jemermed.2020.05.018

Hiccups as the Presenting Manifestation of Cardiac Tamponade: A Case Report

J Emerg Med. 2020 Aug;59(2):291-293. doi: 10.1016/j.jemermed.2020.05.018. Epub 2020 Jul 2.

Authors

Jiashan Chen¹, Jen-Tang Sun¹, Chieh-Min Fan¹, Kuang-Chau Tsai¹, Chih-Jung Chang¹

Affiliation

¹ Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.

PMID: 32622583
DOI: 10.1016/j.jemermed.2020.05.018

Abstract

Background: Cardiac tamponade is a life-threatening disease with a high mortality rate. Its clinical manifestations depend on the length of time over which pericardial effusion accumulates. Among those, hiccups are rarely reported.

Case report: We present a 48-year-old man who came in with a chief complaint of persistent hiccups and later had hypotension and dyspnea at the emergency department. Electrocardiogram revealed diffuse ST elevation with mildly elevated cardiac enzymes. Echocardiography showed massive pericardial effusion, implying cardiac tamponade. Catheter pericardiocentesis was performed and massive pericardial effusion was drained. Hiccups subsided after the procedure and the patient recovered uneventfully. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: To the best of our knowledge, this is the first case of cardiac tamponade with the presenting manifestation of persistent hiccups. Emergency physicians should stay vigilant when approaching those patients with unexplainable prolonged hiccups.

Keywords: ST elevation; cardiac tamponade; hiccups; pericardial effusion.

Publication types

Case Reports

MeSH terms

Cardiac Tamponade* / diagnosis
Cardiac Tamponade* / etiology
Cardiac Tamponade* / surgery
Echocardiography
Hiccup* / etiology
Humans
Male
Middle Aged
Pericardial Effusion* / diagnosis
Pericardial Effusion* / etiology
Pericardial Effusion* / surgery
Pericardiocentesis