# ECG Changes Post-pericardiocentesis for Cardiac Tamponade Secondary to Non-small Cell Carcinoma of the Lung

## TL;DR

A patient with lung cancer developed cardiac tamponade, and ECG changes resolved after pericardiocentesis.

## Contribution

A case report showing ECG normalization after pericardiocentesis in a patient with lung cancer-related cardiac tamponade.

## Key findings

- Electrical alternans on ECG resolved after draining pericardial effusion.
- Biopsy confirmed poorly differentiated non-small cell lung adenocarcinoma.
- Cardiac tamponade symptoms improved following pericardiocentesis.

## Abstract

Electrical alternans on electrocardiograph (ECG) is an uncommon but nearly pathognomonic sign of cardiac tamponade. Here, we present a male quadragenarian who came to the emergency department complaining of low back and right upper abdominal pain. Work-up revealed a large pericardial effusion associated with electrical alternans on ECG and clinical findings of cardiac tamponade. Pericardiocentesis drained approximately 1 liter of hemorrhagic fluid with resolution of cardiac tamponade and normalization of the ECG. Further evaluation with right hilar lymph node biopsy confirmed a diagnosis of poorly differentiated non-small cell adenocarcinoma of the lung.