Activated Prothrombin Complex Concentrate for coagulopathy reversal secondary to ischemic hepatic injury due to cardiac tamponade: A case report

INTRODUCTION AND IMPORTANCE: Correction of coagulopathy is needed before invasive procedures. However, there is limited evidence to support using Prothrombin Complex Concentrate (PCC) to reverse coagulopathy secondary to liver disease. CASE PRESENTATION: We report a case of a 68-year-old male patient a known case of heart failure with preserved ejection fraction, who developed cardiac tamponade, resulting in hemodynamic instability and ischemic liver injury leading to coagulopathy of INR 2.3. Activated PCC (FEIBA) was used to reverse coagulopathy. INR dropped to 1.9 and the procedure was performed uneventfully with successful elimination of tamponade signs evidenced by echocardiography. CLINICAL DISCUSSION: In this case, the patient required an urgent pericardiocentesis. Activated PCC used successfully to reverse coagulopathy, which was important prior to the procedure. CONCLUSION: In view of the need for urgent pericardiocentesis, coagulopathy due to ischemic liver injury could be reversed with the use of activated PCC.