Nickel hypersensitivity has been reported in up to 15% of the general population. However, there are few reported cases of patients developing nickel allergy after cardiac device implantation. This phenomenon is generally not well understood and many authorities believe that these devices are safe. Most reported cases of nickel allergy have presented with non-specific symptoms such as chest pain, palpitations, or pericarditis and the majority of patients have undergone atrial septal defect closure with devices containing nickel, such as the Amplatzer septal occluder device (St Jude Medical). Herein, we describe a case of hypersensitivity pericarditis complicated with cardiac tamponade that responded dramatically to anti-inflammatory therapy. We hypothesize that this hypersensitivity was secondary to nickel allergy.