Recognizing Post-Cardiac Injury Syndrome After Impella 5.5 Insertion in Cardiogenic Shock: A Case-Based Discussion

TL;DR

This paper presents the first case of pericarditis caused by an Impella 5.5 device in a patient with heart failure, highlighting the importance of recognizing this rare complication.

Contribution

The paper reports the first documented case of post-cardiac injury syndrome due to Impella 5.5 insertion.

Findings

A patient developed pericarditis after Impella 5.5 insertion, confirmed by lab results and ECG.

Treatment with Ibuprofen and Colchicine was effective, and the patient later received a heart transplant.

Abstract

The use of temporary mechanical circulatory support in refractory heart failure cardiogenic shock (HFCS) has risen, leading to potential complications. Post-Cardiac Injury Syndrome (PCIS) from Impella insertion is rare but may result from subclavian artery manipulation and aortic irritation. We report the first case of pericarditis (PCIS) caused by Impella 5.5 insertion in an HFCS patient awaiting heart transplantation. The patient developed chest pain, tachycardia, and hypotension post-Impella insertion. Laboratory results and electrocardiograms confirmed PCIS. Treatment with Ibuprofen and Colchicine was successful. He received a heart transplant 14 days later. This case emphasizes recognizing iatrogenic pericarditis after Impella insertion and the need to avoid additional myocardial strain.

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