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.