Cardiac tamponade in an orthotopic liver recipient with pulmonary hypertension

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...

Full description

Saved in:

Bibliographic Details
Published in:	Critical care medicine Vol. 30; no. 3; pp. 699 - 701
Main Authors:	Akinci, Seda B, Gaine, Sean P, Post, Wendy, Merrit, William T, Tan, Henkie P, Winters, Bradford
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD by the Society of Critical Care Medicine and Lippincott Williams & Wilkins 01-03-2002 Lippincott
Subjects:	Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Cardiac Tamponade - complications Cardiac Tamponade - diagnostic imaging Cardiac Tamponade - surgery Echocardiography Emergency and intensive postoperative care (general aspects). Pathophysiology of surgery Female Hemodynamics Humans Hypertension, Pulmonary - complications Intensive care medicine Liver Transplantation Medical sciences Pericardiocentesis Postoperative Complications - diagnostic imaging Postoperative Complications - surgery Sonography Human Postoperative Intensive care Echocardiography Iatrogenic Effusion Respiratory disease Liver Cardiac tamponade Cardiovascular disease Transplantation Recipient Homotransplantation Pulmonary hypertension Pericardium Case study Heart disease Surgery Pericardial disease Complication Diagnosis
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	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
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	0090-3493 1530-0293
DOI:	10.1097/00003246-200203000-00035