Left ventricular diastolic collapse. An echocardiographic sign of regional cardiac tamponade
| Autor: | Pramod K. Mohanty, Kabir Chuttani, Steven L. Schwartz, Natesa G. Pandian, J Simonetti, M. E. Caldeira, James E. Udelson, Kenneth Rosenfield, Brenda S. Kusay |
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| Rok vydání: | 1991 |
| Předmět: |
Adult
Male medicine.medical_specialty Diastole Right atrial Pericardial effusion Ventricular Function Left Pericarditis Postoperative Complications Physiology (medical) Cardiac tamponade Internal medicine medicine Humans Cardiac Surgical Procedures Collapse (medical) Aged business.industry Middle Aged medicine.disease Cardiac Tamponade Echocardiography cardiovascular system Cardiology Female Tamponade Radiology medicine.symptom Cardiology and Cardiovascular Medicine Complication business |
| Zdroj: | Circulation. 83:1999-2006 |
| ISSN: | 1524-4539 0009-7322 |
| Popis: | BACKGROUND Cardiac tamponade after cardiac surgical procedures is often associated with hemodynamically significant localized pericardial effusions. The localized collection of pericardial effusion in the postoperative period and the atypical presentation of cardiac tamponade limit the use of conventional clinical and echocardiographic signs usually seen with a circumferential pericardial effusion. Observation of left ventricular diastolic collapse in the echocardiogram of a patient with postoperative regional cardiac tamponade prompted us to explore the frequency of this sign in regional cardiac tamponade. METHODS AND RESULTS We retrospectively analyzed the echocardiograms of 18 patients with postoperative cardiac tamponade for the following echocardiographic findings: right atrial collapse, right ventricular diastolic collapse, left atrial collapse, and left ventricular diastolic collapse. Three of the 18 patients had circumferential pericardial effusion, and 15 had loculated pericardial effusion; in 10, the effusion was predominantly posterior, and in the other five, it extended laterally or inferiorly. The conventional echocardiographic signs of cardiac tamponade such as right atrial collapse, right ventricular diastolic collapse, and left atrial collapse were present in only 3, 1, and 3 of these 15 patients, respectively, but all exhibited left ventricular diastolic collapse. Increasing pressure within the compartment of a loculated pericardial effusion reaching the limit of pericardial distensibility and consequent transient reversal of transmural left ventricular pressure during diastole are most likely the basis for diastolic collapse of the thick-walled ventricle in a setting of regional cardiac tamponade. CONCLUSIONS We conclude that left ventricular diastolic collapse is a frequent sign of regional cardiac tamponade and could be a useful marker of tamponade in postoperative patients. |
| Databáze: | OpenAIRE |
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