Distension of the oblique pericardial sinus in tamponade due to loculated posterior pericardial effusion

D’Cruz, Ivan A.; Macander, Peter J.; Gross, Charles M.; Pai, Ganesh M.

doi:10.1016/0002-9149(90)91368-g

Cited by 6 publications

(1 citation statement)

References 5 publications

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“…These localized postoperative pericardial effusions or hematomas may cause compression of any cardiac chamber. Isolated com pression of the right atrium [15,[18][19][20][21][22][23][24][25][26][27][28][29][30], left atrium [30,48,49], right ventricle [50][51][52], and left ventricle [53,54] have all been reported.…”

Section: Discussionmentioning

confidence: 99%

Isolated Right Atrial Tamponade after Open Heart Surgery: Role of Echocardiography in Diagnosis and Management

et al. 1995

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Ten patients with isolated right atrial tamponade complicating open heart surgery were identified over a 3.5-year period at three institutions. Clinical manifestations varied but were typically those of decreased perfusion with elevated central venous pressure. Hemodynamically these patients had systemic hypotension and tachycardia with elevated central venous pressure but without elevation of pulmonary artery or pulmonary artery wedge pressures. The correct diagnosis in each case was established by echocardiography; 7 via the transthoracic and 3 via the transesophageal approach. The typical echocardiographic feature was an extrinsic extracardiac mass compressing the atrium. Doppler findings included high flow velocities through the right atria, and color flow demonstrated narrow color jets through compressed, slit-like right atria. Surgical exploration confirmed these findings in each case. We conclude that the combination of clinical awareness and appropriate hemodynamic evaluation can alert the physician to the possibility of isolated right atrial hematoma causing decreased perfusion and/or shock following open heart surgery. Echocardiography using either the transthoracic or transesophageal approach can establish the diagnosis and lead to timely surgical intervention.

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Section: Discussionmentioning

confidence: 99%

Isolated Right Atrial Tamponade after Open Heart Surgery: Role of Echocardiography in Diagnosis and Management

et al. 1995

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Evaluation of pericardial sinuses and recesses by radiographic contrast agent

Vijayvergiya

Singhal

Gupta

2018

IHJ Cardiovascular Case Reports (CVCR)

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Problems and Pitfalls in the Echocardiographic Assessment of Pericardial Effusion

D’Cruz

Constantine

1993

Echocardiography

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The echocardiographic diagnosis of pericardial effusions is usually based on visualization of a sonolucent circumcardiac space of varying width. However, potential fallacies in interpretation can arise if sonolucent spaces adjacent to the heart (pleural effusions, ascites, pericardial cysts) are mistaken for pericardial effusions. Loculated pericardial effusions, especially if unusual in location or configuration, can cause diagnostic difficulty on occasion. The differential diagnosis of various "solid" echoes within a pericardial effusion is of clinical relevance, yet not widely discussed. Inflammatory tissue, neoplastic involvement, pus, caseous material, and extravasated blood all have characteristic echocardiographic morphologies. All of the various reported echocardiographic signs of tamponade do not have the same significance, so that caution is necessary not to over- or under-read tamponade. Chamber collapse can be absent in real tamponade in specific situations. On the other hand, "regional" tamponade can occur if loculated pericardial effusions are sufficiently large and high tension; echocardiographic appearances are "atypical" but diagnostically valuable if correctly interpreted. These and certain other unusual variants of tamponade deserve to be better known among echocardiographers not only because of their intrinsic interest, but also to avoid potential pitfalls in the echocardiographic assessment of patients with suspected disease.

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Distension of the oblique pericardial sinus in tamponade due to loculated posterior pericardial effusion

Cited by 6 publications

References 5 publications

Isolated Right Atrial Tamponade after Open Heart Surgery: Role of Echocardiography in Diagnosis and Management

Isolated Right Atrial Tamponade after Open Heart Surgery: Role of Echocardiography in Diagnosis and Management

Evaluation of pericardial sinuses and recesses by radiographic contrast agent

Problems and Pitfalls in the Echocardiographic Assessment of Pericardial Effusion

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