Lessons of the month 1: Cardiac tamponade: don't forget the pancreas.

Cardiac tamponade is a medical emergency, caused by rapid accumulation of fluid in the pericardium resulting in reduced ventricular filling which may result in pulmonary oedema, shock and death. The common causes of cardiac tamponade include malignancy, uraemia, infectious/idiopathic pericarditis, connective tissue diseases, post-cardiac surgery etc. Early recognition and treatment of the underlying cause of the tamponade along with pericardiocentesis improves the prognosis, otherwise untreated cardiac tamponade universally results in death. We report a rare case of 32-year-old man, who presented with cardiac tamponade due to a pancreatico-pericardial fistula secondary to pancreatitis and was successfully treated by endoscopic therapy. © Royal College of Physicians 2021. All rights reserved.