Peri-Intubation Cardiac Arrest in a Patient With Hypertensive Cardiac Tamponade

Cardiac tamponade is widely known to be associated with life-threatening hypotension and rarely with hypertension. We present the case of a 53-year-old woman with hypertension and echocardiographic features of tamponade who had a cardiac arrest on intubation. The paradoxical hypertension is thought to be due to tachycardia and increased peripheral vascular resistance resulting from the compensatory sympathetic surge following impaired cardiac filling caused by the effusion. In the event of cardiorespiratory failure, pericardiocentesis should be considered before intubation in this set of patients.