The echocardiographic findings in this patient were striking and unusual. Typically, in cardiac tamponade, a moderate to large pericardial effusion surrounds both […]
On right heart catheterization, there was a trend toward equalization of diastolic intracardiac pressures: central venous pressure, 19 mm Hg; pulmonary artery diastolic pressure, 21 mm Hg; and pulmonary capillary wedge pressure, 20 mm Hg. The cardiac index was only 1.6 L/min/m2 and there was 20 mm Hg pulsus paradoxus. Because of the deep posterior location of the pericardial fluid collections, percutaneous pericardiocentesis was not attempted and surgical reexploration was performed. […]
Increased peak early transmitral Doppler flow velocities (1.4 m/s) were consistent with a decrease in the functional left ventricular inflow orifice secondary to atrial compression. In addition, a loculated effusion was present around the right atrium (best seen on apical and subcostal views, Fig 1 and 2), with severe right atrial compression and impairment of right ventricular diastolic filling (right ventricular peak early inflow velocity, 1.8 m/s).
Delayed cardiac tamponade is an uncommon complication following cardiac surgery. Early recognition and management are essential for satisfactory outcome. Echocardiography and right heart catheterization usually provide a definitive diagnosis. A […]
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