Coronary Artery Perforation: A Rare Serious Complication of Pericardiocentesis

The complication risk of pericardiocentesis is relatively low (<2%).1 Performing a pericardiocentesis, even in the setting of tamponade, in patients with pulmonary hypertension remains controversial because of concern for hemodynamic collapse and elevated mortality in some studies.2 Despite the risks in this context, coronary perforation during pericardiocentesis is reported to be rare (<1%).3 However, this specific problem represents one of the most serious and immediate mechanical complications requiring rapid recognition.