Limits...
A case report of ventricular dysfunction post pericardiocentesis: stress cardiomyopathy or pericardial decompression syndrome?

Ayoub C, Chang M, Kritharides L - Cardiovasc Ultrasound (2015)

Bottom Line: We report a case of transient biventricular dysfunction post therapeutic pericardiocentesis, with classic features of stress cardiomyopathy (SCM).In our patient, the clinical and echocardiographic features were more in keeping with Takotsubo-type SCM than pericardial decompression syndrome (PDS).Our case is instructive in challenging our understanding of the aetiology of LV dysfunction complicating pericardiocentesis, and in highlighting the importance of careful clinical evaluation (altered heart rate and dyspnoea) in suspecting acute LV dysfunction after initial clinical improvement with pericardial aspiration.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Concord Repatriation General Hospital, Concord, 2139, NSW, Australia. chadiayoub@yahoo.com.au.

ABSTRACT
We report a case of transient biventricular dysfunction post therapeutic pericardiocentesis, with classic features of stress cardiomyopathy (SCM). In our patient, the clinical and echocardiographic features were more in keeping with Takotsubo-type SCM than pericardial decompression syndrome (PDS). Our case is instructive in challenging our understanding of the aetiology of LV dysfunction complicating pericardiocentesis, and in highlighting the importance of careful clinical evaluation (altered heart rate and dyspnoea) in suspecting acute LV dysfunction after initial clinical improvement with pericardial aspiration.

No MeSH data available.


Related in: MedlinePlus

Transmitral inflow traces showing signicicant respiratory phase variation, consistant with tamponade on first presentation
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4502547&req=5

Fig3: Transmitral inflow traces showing signicicant respiratory phase variation, consistant with tamponade on first presentation

Mentions: His electrocardiogram (ECG) (Fig. 1) demonstrated electrical alternans and bedside transthoracic echocardiography (TTE) revealed a large pericardial effusion with features of cardiac tamponade, including diastolic compression of both right atrium and ventricle (Fig. 2, Additional file 1: Video 1 and Additional file 2: Video 2) and large mitral inflow variation (Fig. 3). Urgent pericardiocentesis was performed with a restricted aspiration of only 600 ml drained initially over the first hour, and a total drainage of 1.8 l of heavily blood-stained pericardial fluid over 36 h. During initial aspiration of pericardial fluid there was immediate symptomatic relief and haemodynamic improvement (heart rate [HR] decreased to 80/min, respiratory rate [RR] decreased to 15 breaths/min and BP increased to 150/70 mmHg).Fig. 1


A case report of ventricular dysfunction post pericardiocentesis: stress cardiomyopathy or pericardial decompression syndrome?

Ayoub C, Chang M, Kritharides L - Cardiovasc Ultrasound (2015)

Transmitral inflow traces showing signicicant respiratory phase variation, consistant with tamponade on first presentation
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4502547&req=5

Fig3: Transmitral inflow traces showing signicicant respiratory phase variation, consistant with tamponade on first presentation
Mentions: His electrocardiogram (ECG) (Fig. 1) demonstrated electrical alternans and bedside transthoracic echocardiography (TTE) revealed a large pericardial effusion with features of cardiac tamponade, including diastolic compression of both right atrium and ventricle (Fig. 2, Additional file 1: Video 1 and Additional file 2: Video 2) and large mitral inflow variation (Fig. 3). Urgent pericardiocentesis was performed with a restricted aspiration of only 600 ml drained initially over the first hour, and a total drainage of 1.8 l of heavily blood-stained pericardial fluid over 36 h. During initial aspiration of pericardial fluid there was immediate symptomatic relief and haemodynamic improvement (heart rate [HR] decreased to 80/min, respiratory rate [RR] decreased to 15 breaths/min and BP increased to 150/70 mmHg).Fig. 1

Bottom Line: We report a case of transient biventricular dysfunction post therapeutic pericardiocentesis, with classic features of stress cardiomyopathy (SCM).In our patient, the clinical and echocardiographic features were more in keeping with Takotsubo-type SCM than pericardial decompression syndrome (PDS).Our case is instructive in challenging our understanding of the aetiology of LV dysfunction complicating pericardiocentesis, and in highlighting the importance of careful clinical evaluation (altered heart rate and dyspnoea) in suspecting acute LV dysfunction after initial clinical improvement with pericardial aspiration.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiology, Concord Repatriation General Hospital, Concord, 2139, NSW, Australia. chadiayoub@yahoo.com.au.

ABSTRACT
We report a case of transient biventricular dysfunction post therapeutic pericardiocentesis, with classic features of stress cardiomyopathy (SCM). In our patient, the clinical and echocardiographic features were more in keeping with Takotsubo-type SCM than pericardial decompression syndrome (PDS). Our case is instructive in challenging our understanding of the aetiology of LV dysfunction complicating pericardiocentesis, and in highlighting the importance of careful clinical evaluation (altered heart rate and dyspnoea) in suspecting acute LV dysfunction after initial clinical improvement with pericardial aspiration.

No MeSH data available.


Related in: MedlinePlus