Document Detail

Prolonged distress and clinical deterioration before pericardial drainage in patients with cardiac tamponade.
MedLine Citation:
PMID:  10744796     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether patients with cardiac tamponade are subject to delays and clinical deterioration before undergoing echocardiography and pericardial drainage. DESIGN: Retrospective study. SETTING: The Montreal Heart Institute, Montreal, Quebec, a cardiology referral centre. PATIENTS: The charts of 50 patients who presented with tamponade were reviewed. Intervals between the appearance of symptoms, consultation, echocardiography and drainage were noted. The presence of clinical deterioration before drainage was evaluated. Causes for delays were investigated. RESULTS: Previous cardiac surgery (74%) was the most common etiology of tamponade. Symptoms were present 6.6+/-5.8 days before consultation. The delay between consultation and echocardiography was 1.2+/-2.0 days (range 0 to 12), and that between echocardiography and drainage was 0.8+/-0.9 days (range 0 to four). Patients underwent drainage 1. 9+/-2.5 days (range 0 to 16) after the initial consultation. Deterioration of the clinical status was noted in 34% of patients before pericardial drainage. An error in the initial diagnosis was present in 36% of patients; the majority of these were incorrectly diagnosed with heart failure. Another 44% of patients had no mention of either a working diagnosis in the chart at admission or the desire to rule out tamponade on the request for echocardiography. CONCLUSION: The proper diagnosis does not appear to be initially considered in up to 80% of patients who present with cardiac tamponade. Clinical deterioration occurs in approximately a third of patients during the interval between consultation and pericardial drainage.
E Larose; A Ducharme; L A Mercier; G Pelletier; F Harel; J C Tardif
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of cardiology     Volume:  16     ISSN:  0828-282X     ISO Abbreviation:  Can J Cardiol     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-04-26     Completed Date:  2000-04-26     Revised Date:  2008-04-09    
Medline Journal Info:
Nlm Unique ID:  8510280     Medline TA:  Can J Cardiol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  331-6     Citation Subset:  IM    
Montreal Heart Institute, Montreal, Canada.
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MeSH Terms
Aged, 80 and over
Cardiac Tamponade / complications,  diagnosis*,  therapy,  ultrasonography
Middle Aged
Time Factors

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

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