Acute Hemorrhagic Cardiac Tamponade as Presenting Findings of Transmural Myocardial Infarction in an Adult Patient

To the Editor: A 70‐year‐old female was admitted for severe precordial pain. Electrocardiograph on admission showed ST‐segment elevation myocardial infarction (STEMI) with inferior wall, examination showed cardiogenic shock, noninvasive blood pressure (NIBP) 50/30 mmHg (1 mmHg = 0.133 kPa), and cardiac troponin I positive. She was diagnosed as acute myocardial infarction (AMI) with cardiogenic shock. Fluid resuscitation and inotropic agents were administered immediately, and systolic blood pressure increased to about 90 mmHg. The patient was transferred to catheterization laboratory immediately after administration of a loading dose of aspirin and clopidogrel. Angiography revealed occlusion at the left distal circumflex artery and culprit vessel [Figure 1a]. Percutaneous coronary intervention (PCI) was performed successfully [Figure 1b], and the intro‐aortic balloon was implanted considering the intraoperative cardiogenic shock.