A Clinical Rescue Pericardiocentesis with Point-of-Care Ultrasound of a Malignant Pericardial Effusion in Emergency Department

Pericardial effusion leading to cardiac tamponade can result from a wide range of underlying causes and may develop either acutely or sub acutely. Because of this variability in presentation, timely recognition and prompt intervention are essential, especially in the emergency department where delays can significantly impact patient outcomes. We describe the case of a 54-year-old woman with advanced lung cancer who presented with progressive respiratory distress. Although her initial vital signs, including blood pressure, appeared relatively stable, further evaluation revealed subtle but important features of early cardiac tamponade. An initial misinterpretation of her electrocardiogram (ECG), along with her seemingly preserved hemodynamics, contributed to a delay in initiating definitive management. Point-of-care ultrasound (POCUS) ultimately played a pivotal role in clarifying her condition.