title: Low-pressure cardiac tamponade: clinical and hemodynamic profile.
abstract: BACKGROUND
  Low-pressure cardiac tamponade is a form of cardiac tamponade in which a comparatively low pericardial pressure results in cardiac compression because of low filling pressure. This syndrome is poorly characterized because only isolated cases have been reported. We conducted a study of its clinical and hemodynamic profiles.
  
  
  RESULTS
  From 1986 through 2004, we evaluated all patients at our institution with combined pericardiocentesis and cardiac catheterization. We identified those patients who fulfilled catheterization-based criteria of low-pressure cardiac tamponade and compared their clinical and catheterization data with those of patients with classic tamponade. A total of 1429 patients with pericarditis were evaluated, 279 of whom underwent combined pericardiocentesis and catheterization. Criteria of low-pressure cardiac tamponade were met in 29, whereas 114 had criteria of classic cardiac tamponade. Patients with low-pressure tamponade less frequently had clinical signs of tamponade, but the rate of constitutional symptoms, use of diuretics, and echocardiographic findings of tamponade were similar in both groups. Patients with low-pressure tamponade showed a significant increase in cardiac output after pericardiocentesis, but they usually had less severe cardiac tamponade compared with patients with classic tamponade. Prognosis was related mainly to the underlying disease.
  
  
  CONCLUSIONS
  Low-pressure cardiac tamponade was identified in 20% of patients with catheterization-based criteria of tamponade. Clinical recognition may be difficult because of the absence of typical physical findings of tamponade in most patients. Although some patients are critically ill, most show a stable clinical condition. However, these patients obtain a clear benefit from pericardiocentesis.
authors.affiliation: Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, P Vall d'Hebron 119-129, 08035 Barcelona, Spain. jsagrist@vhebron.net
authors.forename: Jaume
authors.initials: J
authors.lastname: Sagristà-Sauleda
authors.forename: Juan
authors.initials: J
authors.lastname: Angel
authors.forename: Antonia
authors.initials: A
authors.lastname: Sambola
authors.forename: Joan
authors.initials: J
authors.lastname: Alguersuari
authors.forename: Gaietà
authors.initials: G
authors.lastname: Permanyer-Miralda
authors.forename: Jordi
authors.initials: J
authors.lastname: Soler-Soler
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy; D015897:Comorbidity; D004232:Diuretics; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000000981:diagnostic imaging / Q000503:physiopathology; D011859:Radiography; D012189:Retrospective Studies; D014664:Vasodilation
chemical_list: D004232:Diuretics