title: Proximal Aortic Dissection Complicated by Cardiac Tamponade.
abstract: Cardiac tamponade is a well recognized complication of acute proximal aortic dissection and is almost uniformly fatal if not immediately diagnosed and surgically treated. Pericardiocentesis has an ill-defined and perhaps deleterious role in the management of this condition. Severe concentric left ventricular hypertrophy and intravascular volume depletion may further impede ventricular filling in a patient with cardiac tamponade. We describe the management of a patient who presented in a confused state with an acute proximal aortic dissection complicated by cardiac tamponade and associated with evidence of left ventricular outflow tract obstruction. In such a patient, aggressive fluid administration and emergency surgery should be the treatment of choice.
authors.affiliation: Emory University School of Medicine, Division of Cardiology, 69 Butler Street, Atlanta, GA 30303.
authors.forename: Wendy
authors.initials: W
authors.lastname: Book
authors.forename: Michael
authors.initials: M
authors.lastname: Mollod
authors.forename: Joel M.
authors.initials: JM
authors.lastname: Felner