This premature neonate received parenteral nutrition. The catheter perforated the right atrium. Cardiac tamponade resulted from accumulation of the lipid substance being administered.
Blood is not the only substance which, under pressure, can cause cardiac tamponade. In this case, chylopericardium was iatrogenic. Massive chylopericardium has also been reported as a result of injury to the thoracic duct during cardiac surgery. In a rare condition known as pulmonary lymphangioleiomyomatosis chylous effusion can occur in the pericardial sac as well as in the pleural spaces.