Cardiac tamponade in an orthotopic liver recipient with pulmonary hypertension

被引:16
作者
Akinci, SB [1 ]
Gaine, SP
Post, W
Merrit, WT
Tan, HP
Winters, B
机构
[1] Strong Mem Hosp, Div Transplant Surg, Rochester, NY 14642 USA
[2] Johns Hopkins Univ, Sch Med, Dept Anesthesiol & Crit Care Med, Baltimore, MD USA
[3] Johns Hopkins Univ, Sch Med, Dept Cardiol, Baltimore, MD USA
[4] Johns Hopkins Univ, Sch Med, Dept Pulm Med, Baltimore, MD USA
[5] Hacettepe Univ, Dept Anesthesiol & Reanimat, Ankara, Turkey
关键词
liver transplantation; orthotopic; echocardiography; pericardium; tamponade; pulmonary hypertension;
D O I
10.1097/00003246-200203000-00035
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To describe the clinical, hemodynamic, and echocardiographic findings of cardiac tamponade in a patient with portopulmonary hypertension shortly after orthotropic liver transplantation. Design: Case report. Setting: Surgical intensive care unit of a university teaching hospital. Patient: One patient with portopulmonary hypertension deteriorated progressively after orthotropic liver transplantation and developed cardiogenic shock. Intervention: Serial transthoracic echocardiography showed increased right ventricular pressures and pericardial effusion without evidence of cardiac tamponade. Since right ventricular diastolic collapse may not be present in the setting of pulmonary hypertension and her clinical scenario was consistent with tamponade, pericardiocentesis was performed. Measurements and Main Results: There was dramatic improvement of the clinical, hemodynamic, and echocardiographic variables after pericardiocentesis Conclusion: Pulmonary hypertension may decrease the predictive accuracy of echocardiographic clues for cardiac tamponade. Pericardiocentesis should be considered with clinical suspicion of cardiac tamponade without classic echocardiographic evidence in portopulmonary hypertension.
引用
收藏
页码:699 / 701
页数:3
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