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Results for “Cardiac Tamponade”

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At least 19 recordsLinked to original sources
PubMed1978

Hemodynamic effects of nitroprusside and hydralazine in experimental cardiac tamponade.

Cardiac tamponade is associated with decreased cardiac output and increased systemic vascular resistance. Thus, vasodilator drugs might lower systemic resistance and increase cardiac output. Three groups of dogs were studied during tamponade. Group I received nitroprusside only; group II received blood transfusion and then nitroprusside; group III received hydralazine. In group I, nitroprusside lowered right artrial pressure and systemic resistance; cardiac output was unchanged. In group II, transfusion raised right atrial pressure but not cardiac output. Then nitroprusside raised cardiac output significantly. Hydralazine decreased right atrial pressure less than nitroprusside but decreased vascular resistance and raised cardiac output. Both nitroprusside and hydralazine decreased systemic vascular resistance during tamponade, but only hydralazine raised cardiac output probably because of its lesser effect upon the capacitance vessels. Nitroprusside maintained cardiac output during tamponade despite lowered right atrial pressure but increased cardiac output only after transfusion.

Animals↗
PubMed1979

Low-pressure cardiac tamponade.

An elderly man developed cardiac tamponade from a tuberculous pericardial effusion but without such typical manifestations as pulsus paradoxus and jugular-vein distension. This case illustrates the difficulties in clinical recognition of low-pressure cardiac tamponade, which can develop in the presence of dehydration and hypovolemia. The hemodynamic factors that account for this phenomenon are discussed.

Aged↗
PubMed1977

Early recognition of cardiac tamponade.

Nine patients with cardiac tamponade were seen in an 11-month period. Analysis of the clinical and laboratory data indicated that pulsus paradoxus was the most useful physical sign and echocardiography the most useful investigative technique. Three of nine patients died but in only one was the late recognition of tamponade a possible factor in the outcome. Pericardial fenestrations were required in four patients. Viral pericarditis accounted for the tamponade in three cases. There were two cases each of uremia and malignant disease and one case of tuberculous pericarditis. One other case followed pericardiectomy. In five patients tamponade was the initial manifestation of illness.

Adult↗
PubMed1979

[Cardiac tamponade following open-heart surgery (author's transl)].

Cardiac tamponade occurred in 9 (1,8%) of 488 patients following open-heart surgery. Delayed cardiac tamponade was observed in one case (0,2%). The mediastinal tamponade was caused by early occlusion of the chest tubes, pericardium closure and administration of anticoagulants. A reliable sign of mediastinal tamponade is the expanding cardiac silhouette demonstrated by roentgenogram. In outpatients receiving anticoagulants following open-heart procedures a life-threatening delayed cardiac tamponade may develop.

Adolescent↗
PubMed1979

Haemodynamics of cardiac tamponade during various modes of ventilation.

Cardiac output and pleural, pericardial, arterial and cardiac pressures were measured in baboons during different modes of ventilation in the presence of acute cardiac tamponade. Fluctuations in pleural pressure during intermittent positive pressure ventilation were transmitted to the pericardial fluid. Cardiac output and transmural right ventricular end-diastolic pressure were significantly greater during spontaneous ventilation than during intermittent positive pressure ventilation with or without positive end-expiratory pressure. It is recommended that a patient undergoing surgery for cardiac tamponade be allowed to breathe spontaneously until the chest is opened and the pericardium incised.

Animals↗
PubMed1979

[Cardiac tamponade in malignant tumors].

Among 40 patients with cardiac tamponade observed over the years 1972--1978, 23 (57.5%) had a neoplasm as primary cause of illness. The most common etiology was bronchial carcinoma (13). In 9 cases cardiac tamponade was the first clinical symptom of the tumor. Evacuation of the pericardial fluid by puncture (3), surgical drainage (6) and left parasternal insertion of a plastic catheter (12) brought rapid relief from symptoms in all cases. Six patients survived 3--6 months, while another two have now been followed up for over 5 years. Diagnostic problems and therapeutic possibilities in malignant pericarditis are discussed.

Adult↗
PubMed1978

Extrinsic compression of the heart by tumor masquerading as cardiac tamponade.

A patient with known intrathoracic tumor presented with findings suggestive of cardiac tamponade. At cardiac catheterization, the entire heart was displaced superiorly and anteriorly by the tumor mass, and this accounted for the observed cardiac hemodynamics, in the absence of discernible pericardial effusion.

Cardiac Tamponade↗
PubMed1979

Acute nontraumatic cardiac tamponade.

A 33-year-old man presented with acute nontraumatic cardiac tamponade as a result of pneumococcal pericarditis in association with pneumococcal pneumonia. Hypotension, tachycardia and pulsus paradoxicus, 50 mm Hg, were present. Echocardiographic findings were compatible with cardiac tamponade. Pericardiocentesis was performed. Acute nontraumatic pericardial tamponade in the emergency department presents special problems of diagnosis and management. Diagnosis is based on correlation of data from the history, physical examination, electrocardiogram, chest x-ray films, and a high index of suspicion. Echocardiography to confirm the diagnosis of tamponade and aid in correct placement of the needle in pericardiocentesis is especially helpful.

Adult↗
PubMed1975

[Cardiac tamponade during parenteral feeding through a subclavian catheter (author's transl)].

Among the complications of the cava catheter, cardiac perforation with subsequent cardiac tamponade is in fact the rarest but also the most serious. A perforation of the right ventricle by a cava catheter left in for 7 days is reported. The cardiac tamponade and the resulting shock syndrome could be eliminated by aspirating the fluid which had infused into the pericardial space. Subsequently, the catheter could be removed without complication. The rare but usually serious complication provides an argument for the critical indication of the cava catheter.

Adult↗
PubMed1978

Delayed postoperative cardiac tamponade: diagnosis and management.

Symptoms and signs of decreased cardiac output associated with an elevated venous pressure should alert one to the possibility of delayed cardiac tamponade. Enlargement of the cardiothoracic ratio shown by serial roentgenograms and demonstration of significant pericardial effusion by echocardiogram or radionuclide angiocardiography support the diagnosis. Erratic response of the prothrombin time to administration of warfarin and abnormal results of liver function test are additional clues to its diagnosis. Right heart catheterization documents the presence of tamponade and excludes other diagnostic considerations. Operative decompression of the pericardial space can be accomplished by pericardicentesis, subxiphoid pericardiotomy, median sternotomy, or thoracotomy. Hemodynamic observations following the relief of tamponade assure that an adequate therapeutic procedure has been performed.

Adult↗
PubMed1977

Demonstration of a depressor reflex in acute cardiac tamponade.

Studies from our laboratory have demonstrated the presence of a vagally mediated reflex in acute cardiac tamponade. To determine the effect of thisreflex on cardiac performance, we continuously recorded hemodynamic parameters during induction of tamponade in 16 closed-chest mongrel dogs anesthetized with alpha chloralose. The studies were done 1 to 7 days following the insertion of a catheter in the pericardial sac. With increasing pericardial volume, there was a progressive deterioration of cardiac performance, the most marked changes occuring in the late phases of cardiac tamponade...

Animals↗
PubMed1978

Cardiac tamponade: hemodynamic observations in man.

Hemodynamic studies were performed before and after pericardiocentesis in 19 patients with pericardial effusion. Right atrial pressure decreases significantly, from 16 +/- 4 mm Hg (mean +/- SD) to 7 +/- 5 mm Hg in 14 patients with cardiac tamponade. This change was accompanied by significant increases in cardiac output (3.87 +/- 1.77 to 7 +/- 2.2 l/min) and inspiratory systemic arterial pulse pressure (45 +/- 29 to 81 +/- 23 mm Hg). The remaining five patients did not demonstrate cardiac tamponade, as evidenced by lack of significant change in these hemodynamic parameters. In all patients with tamponade, right ventricular end-diastolic pressure (RVEDP) was elevated and equal to pericardial pressure; equilibration was uniformly absent in patients without tamponade. During gradual fluid withdrawal in the tamponade group, significant hemodynamic improvement was largely confined to the period when right ventricular filling pressure remained equilibrated with pericardial pressure. In 10 patients with tamponade and pulsus paradoxus, pulmonary arterial wedge pressure (PAW) was equal to pericardial pressure except during early inspiration and expiration when it was transiently less and greater, respectively; however, inspiratory right atrial pressure never fell below pericardial pressure. In these 10 patients, PAW decreased significantly following pericardiocentesis (P less than 0.001). In the remaining four patients with tamponade but without pulsus paradoxus, all of whom had chronic renal failure, PAW was consistently higher than pericardial pressure or RVEDP and did not decrease after pericardiocentesis. These data tend to confirm the hypothesis that in patients with tamponade, the venous pressure required to maintain any given cardiac volume is determined by pericardial rather than ventricular compliance. When pericardial compliance determines diastolic pressure in both ventricles, relative filling of the ventricles will be competitive and determined by their respective venous pressures (pulmonary vs systemic), which vary with respiration and alternately favor right and left ventricular filling. This results in pulsus paradoxus. However, if pulmonary arterial wedge pressure is markedly elevated before the onset of tamponade, as in patients with chronic renal failure, then pericardial compliance may only determine right ventricular filling pressure. In such cases, pulsus paradoxus may be absent.

Adult↗
PubMed1979

Cardiac tamponade following penetrating mediastinal injuries: improved survival with early pericardiocentesis.

UNLABELLED: Cardiac tamponade was diagnosed in 197 patients admitted over 20 years (1955-1974) to the Charity Hospital of New Orleans, for emergency treatment of pentrating mediastinal injuries. Of the 197, 174 definitively treated patients followed one of three patterns of management: 96 had OR thoracotomy, 68% were unstable, and preoperative pericardiocentesis reduced mortality from 25 to 11% (p less than 0.01); 44 had emergency thoracotomy, 91% were unstable, and prethoractomy pericardiocentesis decreased mortality from 94 to 63% (p less than 0.05); 34 patients primarily with isolated stab wounds, were treated nonsurgically with pericardiocentesis and observation, only 50% were unstable and there was 15% mortality. Recurrent tamponade did not significantly increase overall or operative mortality in patients with pericardiocentesis. RECOMMENDATIONS: early, even presumptive, diagnosis of tamponade; immediate pericardial decompression via pericardiocentesis; and rapid transfer to OR for thoracotomy or sternotomy and cardiorrhaphy with continous pericardial decompression via intrapericardial catheter.

Adolescent↗
PubMed1979

Invasive aspergillosis presenting as pericarditis and cardiac tamponade.

A 38-year-old leukemic patient developed pericarditis and cardiac tamponade due to Aspergillus niger one month after undergoing bone marrow transplantation. She failed to improve even though amphotericin B and rifampin therapy had been initiated before infection was evident. Her unique case illustrates both the unusual presentations of invasive aspergillosis and the difficulty of diagnosing and treating this increasingly common disease.

Adult↗
PubMed1978

The hemodynamics of cardiac tamponade.

The changes produced by acute pericardial tamponade were examined. Tamponade produced the expected hemodynamic alteration; namely, depression on cardiac output, left ventricular pressure and LV dp/dt and elevation of right atrial and intrapericardial pressures. The mechanism of the hemodynamic disturbances was that the elevation of the intrapericardial pressure produced a negative atrial transmural pressure and disturbed atrial and ventricle filling producing the vicious cycle: diminished venoatrial gradient leads to decreased cardiac output leads to attenuated effect of ventricular systole on atrial filling, and so forth. The myocardial contractility was not impaired in cardiac tamponade.

Animals↗