Title : pericardioesophageal fistula
Author : Mohamed Amr, MD
Affiliation : Department of Internal Medicine, Rochester General Hospital, Rochester, NY.
Corresponding Author : Mohamed Amr, MD
Contact number : 718-764-7202
Affiliation Address : 1425 Portland Avenue, Rochester, NY, 14621.
Email address : amrelwagdycardiol@gmail.com
Funding source : none
Conflict of interest : none
Article type : Clinical image
Word count excluding references : 179
This is a 70-year-old-year-old female with a past medical history of atrial fibrillation. Underwent atrial fibrillation ablation procedure two weeks ago. She is now presenting with pericardial chest pain and dysphagia two weeks after the ablation procedure. Her vital signs are normal, and her physical exam is unrevealing.
CT scan of the chest showed pneumopericardium with evidence of pericardioesophageal fistula. She underwent pericardial window and oesophageal stenting, and her postoperative course was uneventful.
From this case, the critical clinical message is to know that Late-onset chest pain, dysphagia, or endocarditis-like symptoms post atrial fibrillation ablation could be an alarm for fatal complications as Esophagoatrial or Pericardioesophageal fistula. If the diagnosis is delayed, mortality is inevitable. Having a high index of suspicion is the key to early diagnosis.