Left ventricular tamponade - a clinical chameleon.

摘要: We present a 45-year-old patient who had to undergo aortocoronary bypass surgery after acute posterior myocardial infarction. On day twelve, the suddenly developed classic signs of cardiogenic shock including angina, tachycardia, and hypotension. ECG displayed significant ST-elevations troponin T was positive. Echocardiography suspected relevant pericardial effusion. However, typical clinical tamponade(distension jugular veins, paradoxical pulse) were absent. Therefore, computed tomography carried out, which confirmed an isolated left ventricular tamponade resulting in severe diastolic systolic dysfunction with profoundly impaired filling. Immediate operative drainage necessary since percutaneous pericardiocentesis impossible given untypical localization. This case demonstrates that clearcut infarction can be misleading may represent presentation tamponade,particularly setting open-heart surgery.