Left ventricular diastolic collapse. An echocardiographic sign of regional cardiac tamponade.

Chuttani, Kabir; Pandian, Natesa G.; Mohanty, P K; Rosenfield, Ken; Schwartz, Steven; Udelson, James E.; Simonetti, Janet; Kusay, B. S.; Caldeira, Marjory

doi:10.1161/01.cir.83.6.1999

Cited by 103 publications

(47 citation statements)

References 20 publications

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“…Hence, selective compression of the left ventricle may be seen in a significant number of cases. This was seen in 4 patients in one study [7], and was also reported by Jones et al [11] and by Chuttani et al [12]. However, selective compression due to loculated effusion can affect the right atrium and venae cavae [3], right ventricular outflow tract [9], left atrium [13], or a combination of one, two, three, or all four chambers [7].…”

Section: Clinical Diagnosissupporting

confidence: 55%

Experience with cardiac tamponade following open heart surgery

Ball

Morrison

1996

Heart Vessels

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Cardiac tamponade following open heart surgery is well described, although, fortunately, uncommon. Unlike more classical "primary" tamponade, the clinical features are not specific, and this can delay diagnosis. In practice, the threshold for investigation must be low, and echocardiography has been invaluable in the detection and localization of pericardial collections. Several factors are believed to contribute to the likelihood of postoperative tamponade, but the mechanisms are not clearly understood. Resternotomy, under general anesthesia, or subxiphoid pericardiotomy, under local or general anesthesia, are effective forms of treatment. However, recent success with the use of percutaneous pericardiocentesis under echocardiographic guidance has shown that postoperative tamponade can be treated safely and effectively by this method.

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Section: Clinical Diagnosissupporting

confidence: 55%

Experience with cardiac tamponade following open heart surgery

Ball

Morrison

1996

Heart Vessels

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“…A large eVusion with a circumferential echo space of > 1 cm anteriorly or posteriorly is reported to be a powerful predictor of the development of tamponade. 3 Nevertheless, cardiac tamponade is usually a clinical diagnosis which is confirmed by echocardiography, where right ventricular (or right atrial) collapse is usually observed [4][5][6][7] ; however, left ventricular collapse is also seen, especially in the more advanced stages of tamponade, 8 and following cardiac surgery. 9 Rarely, despite life threatening tamponade, right atrial or right ventricular diastolic collapse may not be present in some patients, particularly following cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population

et al. 2000

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The aim of the study was to determine the aetiology of large and symptomatic pericardial eVusions and to review the management and subsequent outcome. A survey was done on a consecutive cases of patients who had undergone percutaneous pericardiocentesis over a 10 year period in a city centre general hospital serving a multiethnic catchment population. In all, 46 patients (24 male, 22 female; age range 16 to 90 years, mean 54 years) underwent a total of 51 pericardial drainage procedures (or attempted pericardiocentesis) between 1989 and 1998. Malignancy (44%), tuberculosis (26%), idiopathic (11%), and post-cardiac surgery (9%) were the most common causes of pericardial eVusion. The most common presenting symptoms were breathlessness (90%), chest pain (74%), cough (70%), abdominal pain (61%) (presumed to be related to hepatic congestion), and unexplained fever (28%). In the 12 cases of tuberculous pericarditis, nine occurred in patients of Indo-Asian origin, and three in patients of AfroCaribbean origin. Fever, night sweats, and weight loss were common among these patients, occurring in over 80% of cases of tuberculous pericarditis. Pulsus paradoxus was the most specific sign (100%) for the presence of echocardiographic features of tamponade, with strongest positive predictive value (100%). Although malignancy remains the most common cause in developed countries, tuberculous disease should be considered in patients from areas where tuberculosis is endemic. Percutaneous pericardiocentesis remains an eVective measure for the immediate relief of symptoms in patients with cardiac tamponade, although its diagnostic yield in tuberculous pericarditis is relatively low. (Postgrad Med J 2000;76:809-813)

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“…An extreme degree of tamponade can result in compression and collapse of the whole RV chamber. A similar mechanism can be operative in the manifestation of left ventricular diastolic collapse (LVDC), when a loculated effusion adjacent to the LV causes tamponade [16]. similar mechanism.b One or more of these signs (RAC, RVDC, and LAC) may be present in a given patient, and their predictive accuracy varies.…”

Section: Echocardiographic Findingsmentioning

confidence: 99%

“…Because the RV and RA walls are often adherent to the chest wall following cardiac surgery, the most common location of the effusion is posterior [16]. Consequently, the typical right-sided findings such as RAC and RVDC may not be seen.…”

Section: Regional Tamponadementioning

confidence: 99%

Recent role of imaging in the diagnosis of pericardial disease

et al. 2002

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Noninvasive cardiac imaging techniques have made a striking impact on the evaluation and management of pericardial disorders. Two-dimensional and Doppler echocardiography are the methods of choice in the evaluation of pericardial effusion and cardiac tamponade. Magnetic resonance imaging, computed tomography, and transesophageal echocardiography are valuable in the assessment of pericardial thickness in suspected cases of constrictive pericarditis. Filling dysfunction associated with constrictive pericarditis is well demonstrated by Doppler flow velocity recordings of intracardiac flow jets, and pulmonary and hepatic venous flow streams. Tissue Doppler echocardiography, by which tissue velocity of myocardial regions and mitral annulus are analyzed, offers additional information in the differentiation of constrictive pericarditis and restrictive cardiomyopathy. Magnetic resonance imaging and computed tomography are the techniques of choice in the recognition of unusual disorders such as pericardial cysts, tumors invading the pericardium, and congenital absence of pericardium. Noninvasive imaging aids not only in the diagnosis of pericardial diseases, but also in the guidance of optimal therapy.

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Left ventricular diastolic collapse. An echocardiographic sign of regional cardiac tamponade.

Abstract: 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.

Cited by 103 publications

References 20 publications

Experience with cardiac tamponade following open heart surgery

Experience with cardiac tamponade following open heart surgery

Management of pericardial effusion by drainage: a survey of 10 years' experience in a city centre general hospital serving a multiracial population

Recent role of imaging in the diagnosis of pericardial disease

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