Document Detail


Cardiac tamponade masking clinical presentation and hemodynamic effects of papillary muscle rupture after acute myocardial infarction.
MedLine Citation:
PMID:  12221421     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 67-year-old woman sustained an acute lateral-wall myocardial infarction and was treated with thrombolytic therapy. Postinfarction hypotension developed 3 days later. Clinical findings at that time were consistent with cardiac tamponade, and an echocardiographic study revealed a moderate-sized pericardial effusion. She underwent urgent pericardiocentesis with transient improvement in hemodynamics, followed by deterioration associated with the development of acute pulmonary edema. Follow-up transesophageal echocardiographic imaging revealed papillary muscle rupture with severe mitral regurgitation. The patient underwent urgent surgical intervention consisting of coronary artery bypass grafting and mitral valve replacement. The presence of cardiac tamponade in this patient masked the clinical manifestations of papillary muscle rupture through the hemodynamic effect of tamponade physiology on mitral regurgitation.
Authors:
Monvadi B Srichai; Ivan P Casserly; Harry M Lever
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  15     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-10     Completed Date:  2003-01-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-3     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Tamponade / etiology,  physiopathology,  ultrasonography*
Coronary Artery Bypass
Diagnosis, Differential
Echocardiography / methods
Female
Heart Rupture, Post-Infarction / complications,  physiopathology,  ultrasonography*
Hemodynamics
Humans
Mitral Valve Insufficiency / etiology,  surgery
Papillary Muscles / ultrasonography*
Pericardial Effusion / complications,  physiopathology,  ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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