Tension Pneumopericardium Secondary to Gastropericardial Fistula Presenting as Acute Pericarditis With Cardiac Tamponade Physiology

A 44-year-old man with prior Nissen fundoplication presented with chest pain, hypotension, tachycardia, and inferior ST-segment elevation on electrocardiography. Coronary angiography demonstrated normal coronaries, and left ventriculography revealed radiolucency in the pericardial space ([Figure 1