Unusual presentation of an unusual complication after rescue angioplasty for acute myocardial infarction

Hemorrhagic pericarditis and pericardial tamponade occurring in the setting of acute myocardial infarction (MI) are very uncommon. Even rare is its presentation as acute liver failure. We describe a patient who presented with acute liver failure postangioplasty and stenting of left anterior descending and right coronary artery in the setting of a large transmural anterior wall MI. Acute liver failure in this case was attributable to a hemorrhagic pericardial effusion and tamponade. It completely resolved following pericardiocentesis. This unusual presentation of an unusual complication and its management is discussed.