Cardiac tamponade in left ventricular dysfunction
| Autor: | Noble O. Fowler, Brian D. Hoit, Marjorie Gabel |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
Pericardial constriction Heart Ventricles Coronary Disease Electrocardiography Dogs Physiology (medical) Cardiac tamponade Internal medicine medicine Animals cardiovascular diseases Pulse medicine.diagnostic_test business.industry Hemodynamics Pulsus paradoxus Pericardial fluid Heart medicine.disease Cardiac Tamponade Blood pressure Anesthesia cardiovascular system Ventricular pressure Cardiology Tamponade medicine.symptom Cardiology and Cardiovascular Medicine business Pericardium |
| Zdroj: | Circulation. 82:1370-1376 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.82.4.1370 |
| Popis: | Echocardiographic and hemodynamic data were measured in closed-chest dogs during graded cardiac tamponade (pericardial pressure 5, 10, and 15 mm Hg) before and after production of diffuse ischemic left ventricular dysfunction. Left ventricular dysfunction was produced by intracoronary injection of nonradioactive microspheres (54 +/- 3.9 mm diameter). Changes in left atrial pressure with cardiac tamponade were influenced by coexisting left ventricular dysfunction. Left atrial pressure increased with tamponade and was equal to pericardial pressure before left ventricular dysfunction was produced. However, after left ventricular dysfunction was produced, left atrial pressure was significantly higher than pericardial pressure before tamponade, but it fell toward pericardial pressure when tamponade was produced. Pulsus paradoxus (greater than 10 mm Hg) was present in all animals with cardiac tamponade before left ventricular dysfunction but in only one animal afterward. During each level of tamponade, the inspiratory fall of aortic systolic pressure was greater before than with left ventricular dysfunction. The slope of the linear regression between pericardial pressure and millimeters of mercury of inspiratory fall in aortic systolic pressure was significantly greater before than with left ventricular dysfunction (0.74 +/- 0.12 versus 0.32 +/- 0.12, p less than 0.05). Left ventricular dysfunction caused a leftward and upward shift of the pericardial pressure-volume relation. As a result, right atrial and ventricular collapse occurred with significantly smaller volumes of pericardial fluid after than before left ventricular dysfunction. We conclude that pulsus paradoxus may be absent in cardiac tamponade with coexisting left ventricular dysfunction and unequal filling pressures. Echocardiographic signs of cardiac tamponade may occur with small effusions in the presence of left ventricular dysfunction. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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