Left ventricular diastolic collapse. An echocardiographic sign of regional cardiac tamponade
- PMID: 2040053
- DOI: 10.1161/01.cir.83.6.1999
Left ventricular diastolic collapse. An echocardiographic sign of regional cardiac tamponade
Abstract
Background: Cardiac tamponade after cardiac surgical procedures is often associated with hemodynamically significant localized pericardial effusions. The localized collection of pericardial effusion in the postoperative period and the atypical presentation of cardiac tamponade limit the use of conventional clinical and echocardiographic signs usually seen with a circumferential pericardial effusion. Observation of left ventricular diastolic collapse in the echocardiogram of a patient with postoperative regional cardiac tamponade prompted us to explore the frequency of this sign in regional cardiac tamponade.
Methods and results: We retrospectively analyzed the echocardiograms of 18 patients with postoperative cardiac tamponade for the following echocardiographic findings: right atrial collapse, right ventricular diastolic collapse, left atrial collapse, and left ventricular diastolic collapse. Three of the 18 patients had circumferential pericardial effusion, and 15 had loculated pericardial effusion; in 10, the effusion was predominantly posterior, and in the other five, it extended laterally or inferiorly. The conventional echocardiographic signs of cardiac tamponade such as right atrial collapse, right ventricular diastolic collapse, and left atrial collapse were present in only 3, 1, and 3 of these 15 patients, respectively, but all exhibited left ventricular diastolic collapse. Increasing pressure within the compartment of a loculated pericardial effusion reaching the limit of pericardial distensibility and consequent transient reversal of transmural left ventricular pressure during diastole are most likely the basis for diastolic collapse of the thick-walled ventricle in a setting of regional cardiac tamponade.
Conclusions: 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.
Similar articles
-
Left ventricular diastolic collapse in regional left heart cardiac tamponade. An experimental echocardiographic and hemodynamic study.J Am Coll Cardiol. 1993 Sep;22(3):907-13. doi: 10.1016/0735-1097(93)90210-r. J Am Coll Cardiol. 1993. PMID: 8354831
-
Diagnosis of cardiac tamponade after cardiac surgery: relative value of clinical, echocardiographic, and hemodynamic signs.Am Heart J. 1994 Apr;127(4 Pt 1):913-8. doi: 10.1016/0002-8703(94)90561-4. Am Heart J. 1994. PMID: 8154431
-
Left ventricular cardiac tamponade in the setting of cor pulmonale and circumferential pericardial effusion. Case report and review of the literature.Cardiol Rev. 2005 Jul-Aug;13(4):214-7. doi: 10.1097/01.crd.0000151499.06046.48. Cardiol Rev. 2005. PMID: 15949058 Review.
-
Diastolic collapse of the right ventricle with cardiac tamponade: an echocardiographic study.Circulation. 1982 Jun;65(7):1491-6. doi: 10.1161/01.cir.65.7.1491. Circulation. 1982. PMID: 7074806
-
What echocardiographic findings suggest a pericardial effusion is causing tamponade?Am J Emerg Med. 2019 Feb;37(2):321-326. doi: 10.1016/j.ajem.2018.11.004. Epub 2018 Nov 17. Am J Emerg Med. 2019. PMID: 30471929 Review.
Cited by
-
How do the clinical findings in patients with pericardial effusions influence the success of aspiration?Br Heart J. 1995 Apr;73(4):351-4. doi: 10.1136/hrt.73.4.351. Br Heart J. 1995. PMID: 7756068 Free PMC article.
-
A Misleading Left Atrial Appendage.JACC Case Rep. 2023 May 6;15:101872. doi: 10.1016/j.jaccas.2023.101872. eCollection 2023 Jun 7. JACC Case Rep. 2023. PMID: 37283826 Free PMC article.
-
A case of right ventricular diastolic dysfunction due to a large hematoma posterior to the left ventricle.J Cardiol Cases. 2015 Mar 21;12(1):8-11. doi: 10.1016/j.jccase.2015.02.007. eCollection 2015 Jul. J Cardiol Cases. 2015. PMID: 30534268 Free PMC article.
-
Pericardial effusion after cardiac surgery: incidence, site, size, and haemodynamic consequences.Br Heart J. 1994 Oct;72(4):327-31. doi: 10.1136/hrt.72.4.327. Br Heart J. 1994. PMID: 7833189 Free PMC article.
-
Echocardiography of isolated subacute left heart tamponade in a patient with cor pulmonale and circumferential pericardial effusion.Cardiovasc Ultrasound. 2010 Jul 14;8:27. doi: 10.1186/1476-7120-8-27. Cardiovasc Ultrasound. 2010. PMID: 20630052 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical