Late partial tamponade of the right atrium. A case report.
An unusual case of late partial tamponade of the right atrium is reported in a patient 35 days after aortic valve replacement. Chest x-rays, echocardiograms and ECG were not helpful. The diagnosis was made by emergency bedside right heart catheterization which showed a 7 cm H2O gradient between the junction of the superior vena cava and right atrium and also a 12 cm H2O pressure difference between the femoral vein and the right atrium with a normal capillary wedge pressure. Re-thoracotomy with evacuation of blood clots and control of bleeding points improved the hemodynamics dramatically. However the patient succumbed 3 weeks later due to irreversible brain damage. This is thought to be the first report of a late partial right atrial tamponade in the English medical literature.
D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D002305:Cardiac Tamponade / Q000209:etiology* / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D004630:Emergencies; D006325:Heart Atria; D006349:Heart Valve Diseases / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012214:Rheumatic Heart Disease / Q000601:surgery*; D013997:Time Factors