Left Ventricular Collapse Secondary to Pericardial Effusion Treated with Pericardicentesis and Percutaneous Pericardiotomy in Severe Pulmonary Hypertension

Aqel, Raed; AlJaroudi, Wael; Hage, Fadi G.; Tallaj, José; Rayburn, Barry K.; Nanda, Navin C.

doi:10.1111/j.1540-8175.2008.00661.x

Cited by 23 publications

(16 citation statements)

References 11 publications

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“…Experimental studies demonstrate that RV diastolic indentation is more sensitive, specific, and has a better predictive value of cardiac tamponade than pulsus paradoxus (26). Collapse of the LV is unusual, due to its thicker wall and may be seen in patients with severe pulmonary hypertension (31) or loculated PEff, typically around the free posterior wall of the LV following cardiac surgery (32) (Figure 9). …”

Section: Cardiac Tamponadementioning

confidence: 99%

Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade

et al. 2017

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Pericardial effusion (PEff) is defined by an increase in the physiological amount of fluid within the pericardial space. It can appear following different medical conditions, mainly related to inflammation and cardiac surgery. Cardiac tamponade is a critical condition that occurs after sudden and/or excessive accumulation of fluid in the pericardial space that restricts appropriate filling of the cardiac chambers disturbing normal hemodynamics and ultimately causing hypotension and cardiac arrest. It is, therefore, a life-threatening condition that must be diagnosed as soon as possible for correct treatment and management. Echocardiographic evaluation of PEff is paramount for timely and appropriate diagnosis and management. A structured echocardiographic approach including two-dimensional, M-mode, and Doppler echocardiographic evaluation assessing (i) quantity and quality of pericardial fluid, (ii) collapse of cardiac chambers, (iii) respiratory variation of the ventricular diameters, (iv) inferior vena cava collapsibility, and (v) flow patterns in atrioventricular valves should give the bedside clinician the necessary information to appropriately manage PEff. Here, we review these key echocardiographic signs that will ensure an appropriate assessment of a patient with PEff and/or cardiac tamponade.

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Section: Cardiac Tamponadementioning

confidence: 99%

Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade

et al. 2017

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“…In general, draining pericardial effusions should be avoided. Although anecdotal case reports suggest that opening of the pericardium may improve cardiac function (85), two small series reported 50% mortality in patients who had their effusion drained (86,87).…”

Section: Percutaneous Interventionsmentioning

confidence: 99%

Intensive Care Unit Management of Patients with Severe Pulmonary Hypertension and Right Heart Failure

Hoeper

Granton

2011

Am J Respir Crit Care Med

273

249

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Despite advances in medical therapies, pulmonary arterial hypertension (PAH) continues to cause significant morbidity and mortality. Although the right ventricle (RV) can adapt to an increase in afterload, progression of the pulmonary vasculopathy that characterizes PAH causes many patients to develop progressive right ventricular failure. Furthermore, acute right ventricular decompensation may develop from disorders that lead to either an acute increase in cardiac demand, such as sepsis, or to an increase in ventricular afterload, including interruptions in medical therapy, arrhythmia, or pulmonary embolism. The poor reserve of the right ventricle, RV ischemia, and adverse right ventricular influence on left ventricular filling may lead to a global reduction in oxygen delivery and multiorgan failure. There is a paucity of data to guide clinicians caring for acute right heart failure in PAH. Treatment recommendations are frequently based on animal models of acute right heart failure or case series in humans with other causes of pulmonary hypertension. Successful treatment often requires that invasive hemodynamics be used to monitor the effect of strategies that are based primarily on biological plausibility. Herein we have developed an approach based on the current understanding of RV failure in PAH and have attempted to develop a treatment paradigm based on physiological principles and available evidence.

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“…7 LV collapse with free pericardial effusion has rarely been reported 8,9 and, in these situations, the hypertrophied RV in preexisting pulmonary hypertension causes the LV to collapse because the intrapericardial pressure exceeds the LV diastolic, but not the RV diastolic pressure.…”

Section: Discussionmentioning

confidence: 98%

Isolated Left Ventricular Diastolic Collapse in Pericardial Tamponade: An Uncommon Echocardiographic Finding

et al. 2014

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A case of circumferential moderate pericardial effusion causing isolated collapse of left ventricular cavity on two-dimensional echocardiography is reported. Pericardial effusion, mostly of infective etiology, is relatively common in this part of the world. When large enough to cause tamponade, collapse of right atrium, right ventricle, and uncommonly left atrium can be seen. Left ventricular collapse is rare, both due to the larger muscle mass and higher chamber pressure.

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Left Ventricular Collapse Secondary to Pericardial Effusion Treated with Pericardicentesis and Percutaneous Pericardiotomy in Severe Pulmonary Hypertension

Cited by 23 publications

References 11 publications

Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade

Echocardiographic Evaluation of Pericardial Effusion and Cardiac Tamponade

Intensive Care Unit Management of Patients with Severe Pulmonary Hypertension and Right Heart Failure

Isolated Left Ventricular Diastolic Collapse in Pericardial Tamponade: An Uncommon Echocardiographic Finding

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