The decreasing diuresis could be the first sign of accumulating pericardial fluid and thriving pericardial tamponade
on cardiac surgical ICU.
If cardiac surgery is unavoidable for patients with pericardial tamponade
, the best time window is within 3 hrs after balloon occlusion, when the protective effect of IPC is maximal.
The patient who was thought to have pericardial tamponade
clinically and echocardiographically was taken into the catheter room and pericardiocentesis was performed under guidance of ultrasonography.
Inspiratory displacement of the interventricular septum towards the left ventricle is a moderately sensitive sign for pericardial tamponade
, especially in the cardiac postoperative patient with altered hemodynamics, good LV function, and evidence of pericardial effusion.
If wire fragments migrate into the vicinity of the posterior neurovascular bundle, they have the potential to lacerate the popliteal vessels and migrate distally via either the venous or arterial system and act as emboli causing damage to distal vessels or cardiac complications such as cardiac arrythmia, pericardial tamponade
, and death.
While changes in ECMO cannula design have improved considerably the ease of percutaneous insertion, the inclusion of a cardiac surgeon in these retrievals is invaluable should open cannulation be required or should complications occur (such as our patient who developed pericardial tamponade
: A critical determinant for survival following penetrating cardiac wounds.
Accelerated nodulosis, pleural effusion, and pericardial tamponade
during methotrexate therapy.
All experts agreed that the cause of death was pericardial tamponade
. The patient's daughter, in her capacity as the administratrix of her mother's estate, brought suit against Akron General Medical Center, alleging that her mother's death was negligently caused during the procedure in question.
CASE REPORT: A 2-year-old male patient was admitted with a pericardial tamponade
, for which a percutaneous drain was inserted.
* Idiopathic 29% * Malignancy 13% * Uremia 6% * Iatrogenic 16% * Postmyocardial infarction 8% * Infection 2% * Collagen vascular disease 5% * Hypothyroidism 0% * Other 21% Most pericardial effusions never progress to pericardial tamponade
; however, bacterial (including mycobacterial), fungal, and HIV-associated infections, neoplastic involvement, and any form of bleeding into the pericardial space may progress to cardiac tamponade.
Malignant pericardial effusions are common in cancer patients, and until now the resulting pericardial tamponade
has been the immediate cause of death in 85% of affected patients.