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KMID : 0882420080740000254
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Korean Journal of Medicine
2008 Volume.74 No. 0 p.254 ~ p.259
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A case of hemorrhagic cardiac tamponade in a patient on low molecular weight heparin for hemodialysis
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Kim So-Mi
Yoo Woo-Joo
Heun Jin-Nam
Kim Sunk-Yung
Park Sang-Eun
Lee Sun-Mi
Kim Na-Ri
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Abstract
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Low molecular weight heparin has some distinct advantages over unfractionated heparin. It is more bio-available, and laboratory monitoring is not necessary. Compared with unfractionated heparin, low molecular weight heparin does not result in an increased risk of major bleeding. However, bleeding tendency is not predictable in patients with renal failure, because low molecular weight heparin does not alter prothrombin times or partial thromboplastin times, making prediction of anticoagulation state impossible in these patients whose elimination of low molecular weight heparin is delayed. Recently, we treated a case of enoxaparin-associated hemorrhagic cardiac tamponade in a chronic dialysis patient. A 56-year-old man developed hemorrhagic cardiac tamponade during treatment with enoxaparin (40 mg). He experienced sudden dyspnea, mental status change, and hypotension. His vital signs were stabilized through cardiocentesis and conservative treatment. Low molecular weight heparin is a useful anticoagulant, but it may cause serious bleeding in hemodialysis patients. (Korean J Med 74:S254-S259, 2008)
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KEYWORD
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Hemorrhagic cardiac tamponade, Low molecular weight heparin, Hemodialysis
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