Cardiac tamponade presenting as obstructive shock in the first trimester pregnancy – a case report

TL;DR

A pregnant woman in her first trimester experienced life-threatening heart complications due to cardiac tamponade, highlighting the need for early diagnosis and treatment.

Contribution

This is the first reported case of cardiac tamponade in early pregnancy, offering insights into its evaluation and management.

Findings

Cardiac tamponade in early pregnancy can present as obstructive shock and is potentially fatal.

Point-of-care ultrasound is crucial for early detection in pregnant patients with unexplained hemodynamic instability.

Pericardiocentesis can be safely performed in such cases to manage pericardial effusion.

Abstract

Cardiac tamponade is a critical emergency that needs to be recognized and treated without delay. There is a significant knowledge gap regarding cardiac tamponade in early pregnancy, with no reported cases or guidelines on its evaluation and management. The impact of hemodynamic instability on maternal and fetal outcomes remains unclear.

We present a case of 24-year-old gravida 2 para 1 living 1 (G2P1L1) antenatal mother with no prior co-morbidities who developed sudden cardiovascular collapse secondary to cardiac tamponade caused by massive pericardial effusion. The patient did not survive despite timely aggressive resuscitative efforts, owing to refractory shock from severe myopericarditis probably viral origin.

This case highlights the importance of early point – of – care ultrasound (POCUS) evaluation of pregnant female presenting with unexplained hemodynamic instability and provides critical information on the safety and efficacy of pericardiocentesis in this unique clinical scenario.

The online version contains supplementary material available at 10.1186/s12245-026-01120-5.

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