title: Usefulness of transesophageal echocardiography for identifying the precise location of a left ventricular rupture in a patient with collapsed cardiac chamber.
abstract: We report an emergent case of cardiac tamponade due to rupture of the left ventricle. Preload and intracardiac volume were decreased by percutaneous cardiopulmonary support (PCPS), which led to the collapse of the cardiac chamber. The collapsed cardiac chamber made it difficult to diagnose cardiac abnormalities by preoperative transthoracic echocardiography (TTE). On loading fluid infusion and transfusion as volume load to improve the hemodynamic status, transesophageal echocardiography (TEE) revealed several leakages in the left ventricular myocardium. Continuous careful observation on TEE led us to a confident diagnosis of left ventricular rupture. The diagnosis by TEE also led to the employment of the appropriate procedure. TEE is useful for detecting an abnormality due to the location of the cardiac chamber and echocardiographic probe. We also note that continuous careful observation led to the employment of the appropriate procedure.
authors.affiliation: Department of Anesthesiology, National Cardiovascular Center, Suita, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Nakahira
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ohnishi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nohmi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sawai
authors.forename: Masakazu
authors.initials: M
authors.lastname: Kuro
mesh_terms: D022561:Advanced Cardiac Life Support; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D017548:Echocardiography, Transesophageal; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D011300:Preoperative Care; D012422:Rupture, Spontaneous; D012769:Shock / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*