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The Journal of Thoracic and Cardiovascular Surgery, Vol 84, 413-419, Copyright © 1982 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Right atrial tamponade complicating cardiac operation: clinical, hemodynamic, and scintigraphic correlates

T Bateman, R Gray, A Chaux, M Lee, M De Robertis, D Berman and J Matloff

Persistent bleeding into the pericardial space in the early hours after cardiac operation not uncommonly results in cardiac tamponade. Single chamber tamponade also might be expected, since in this setting the pericardium frequently contains firm blood clots localized to the area of active bleeding. However, this complication has received very little attention in the surgical literature. We are therefore providing documentation that isolated right atrial tamponade can occur as a complication of cardiac operation and that there exists a potential for misdiagnosis and hence incorrect treatment of this condition. Right atrial tamponade may be recognized by a combination of low cardiac output, low blood pressure, prominent neck veins, right atrial pressure in excess of pulmonary capillary wedge pressure and right ventricular end-diastolic pressure, and a poor response to plasma volume expansion. Findings on chest roentgenogram and gated wall motion scintigraphy may be highly suggestive. This review should serve to increase awareness of this complication and to provide some helpful diagnostic clues.


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C. G. Koch
The Use of Echocardiography in the Intensive Care Unit
Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1998; 2(1): 52 - 65.
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