Martin J. Frey, MD; Barbara Berko, MD; Harold Palevsky, MD; John W. Hirshfeld Jr., MD; Howard C. Herrmann, MD
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
Frey MJ, Berko B, Palevsky H, Hirshfeld JW, Herrmann HC. Recognition of Cardiac Tamponade in the Presence of Severe Pulmonary Hypertension. Ann Intern Med. ;111:615–617. doi: 10.7326/0003-4819-111-7-615
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Published: Ann Intern Med. 1989;111(7):615-617.
Cardiology, Pericardial Disease, Pulmonary Hypertension, Pulmonary/Critical Care.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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