RSS Feeds
Recognition of Cardiac Tamponade in the Presence of Severe Pulmonary Hypertension
- Martin J. Frey, MD;
- Barbara Berko, MD;
- Harold Palevsky, MD;
- John W. Hirshfeld, Jr., MD; and
- Howard C. Herrmann, MD
Excerpt
The clinical features of cardiac tamponade in a patient with a pericardial effusion may include dyspnea, elevated systemic venous pressure, and pulsus paradoxus. Right ventricular diastolic collapse (RVDC) on M-mode or two-dimensional echocardiography is an early and sensitive sign providing additional evidence for the diagnosis of tamponade (1). The hemodynamic observations of elevated and equal diastolic pressures in all cardiac chambers, hypotension, and a decreased cardiac output that return to normal after removal of the effusion confirm the diagnosis (2). However, the clinical recognition of cardiac tamponade in patients with pulmonary hypertension is more difficult. These patients typically have elevated
Acknowledgments
Acknowledgments: The authors thank Nathaniel Reichek, MD, for his thoughtful comments and Cheryl Somers for secretarial assistance.
Article and Author Information
-
From the Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania. For current author addresses, see end of text.
-
Requests for Reprints: Howard C. Herrmann, MD, Cardiovascular Section, 9 Founder's Pavilion, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.
-
Current Author Addresses: Dr. Frey: Sarasota Heart Center, 1950 Arlington Street, Sarasota, FL 34239.
Dr. Berko: The Medical Center at Princeton, 253 Witherspoon Street, Princeton, NJ 08540.
Dr. Palevsky: Cardiovascular-Pulmonary Division, 975 Maloney Building, Hospital of the University of Pennsylvania, 3600 Spruce Street, Philadelphia, PA 19104.
Drs. Hirshfeld and Herrmann: Cardiovascular Section, 9 Founder's Pavilion, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.
