Cardiac tamponade in an orthotopic liver recipient with pulmonary hypertension

Seda B. Akinci, Sean P. Gaine, Wendy S Post, William T Merritt, Henkie P. Tan, Bradford D Winters

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)699-701
Number of pages3
JournalCritical Care Medicine
Volume30
Issue number3
StatePublished - 2002

Fingerprint

Cardiac Tamponade
Pericardiocentesis
Pulmonary Hypertension
Liver
Hypertension
Liver Transplantation
Hemodynamics
Cardiogenic Shock
Pericardial Effusion
Ventricular Pressure
Critical Care
Teaching Hospitals
Intensive Care Units
Echocardiography

Keywords

  • Echocardiography
  • Liver transplantation
  • Orthotopic
  • Pericardium
  • Pulmonary hypertension
  • Tamponade

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Cardiac tamponade in an orthotopic liver recipient with pulmonary hypertension. / Akinci, Seda B.; Gaine, Sean P.; Post, Wendy S; Merritt, William T; Tan, Henkie P.; Winters, Bradford D.

In: Critical Care Medicine, Vol. 30, No. 3, 2002, p. 699-701.

Research output: Contribution to journalArticle

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AU - Akinci, Seda B.

AU - Gaine, Sean P.

AU - Post, Wendy S

AU - Merritt, William T

AU - Tan, Henkie P.

AU - Winters, Bradford D

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N2 - 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.

AB - 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.

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