Implications of echocardiographically assisted diagnosis of pericardial tamponade in contemporary medical patients: detection before hemodynamic embarrassment.

摘要: Identification of suspected pericardial tamponade and the decision to perform invasive drainage space have historically been based on classic bedside findings. Two-dimensional echocardiography has improved detection effusion, but it may be excessively sensitive in evaluation patients for hemodynamic embarrassment. Therefore, 50 consecutive medical were examined who identified by probable (defined as presence right heart chamber collapse a effusion) underwent combined right-sided cardiac catheterization percutaneous pericardiocentesis. All had elevated pressure. However, many minimal evidence compromise (94% systolic blood pressure greater than or equal 100 mm Hg 58% index 2.3 liters/min per m2). Pericardiocentesis resulted improvement, frequently did not alleviate dyspnea correct tachycardia. Patients with malignancy cause high mortality rate (the cumulative probability survival such was only 17% at 1 year). Echocardiographically assisted diagnosis results identification substantial subset subtle compromise. This differs sharply from described previous reports tamponade. Although can managed catheter pericardiocentesis few complications, natural history optimal management strategy this group are resolved.