title: Cardiac tamponade in an orthotopic liver recipient with pulmonary hypertension.
abstract: OBJECTIVE
  To describe the clinical, hemodynamic, and echocardiographic findings of cardiac tamponade in a patient with portopulmonary hypertension shortly after orthotropic liver transplantation.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Surgical intensive care unit of a university teaching hospital.
  
  
  METHODS
  One patient with portopulmonary hypertension deteriorated progressively after orthotropic liver transplantation and developed cardiogenic shock.
  
  
  METHODS
  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.
  
  
  RESULTS
  There was dramatic improvement of the clinical, hemodynamic, and echocardiographic variables after pericardiocentesis
  
  
  CONCLUSIONS
  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.
authors: Department of Anesthesiology & Reanimation, Hacettepe University, Ankara, Turkey.
authors: Seda B
authors: SB
authors: Akinci
authors: Sean P
authors: SP
authors: Gaine
authors: Wendy
authors: W
authors: Post
authors: William T
authors: WT
authors: Merrit
authors: Henkie P
authors: HP
authors: Tan
authors: Bradford
authors: B
authors: Winters
mesh_terms: D000328:Adult; D002305:Cardiac Tamponade / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D016031:Liver Transplantation; D020519:Pericardiocentesis; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery