Cardiac tamponade in an orthotopic liver recipient with pulmonary hypertension.
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.
Akinci
Seda B
SB
Department of Anesthesiology & Reanimation, Hacettepe University, Ankara, Turkey.
Gaine
Sean P
SP
Post
Wendy
W
Merrit
William T
WT
Tan
Henkie P
HP
Winters
Bradford
B
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