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Ann Thorac Surg 1983;36:353-358
© 1983 The Society of Thoracic Surgeons

Articles

Right Ventricular Outflow Obstruction Secondary to Right-sided Tamponade Following Myocardial Trauma

Thomas F. Phillips, M.D.*, Aurelio Rodriguez, M.D, R. Adams Cowley, M.D.

From the Maryland Institute for Emergency Medical Services Systems, Baltimore, MD

Accepted for publication November 18, 1982.

* Address reprint requests to Dr. Phillips, Department of Surgery 4S-13, Detroit Receiving Hospital, 4201 St. Antoine, Detroit, MI 48201

A case of isolated tamponade of the right side of the heart, seen as an abrupt change in the cardiac silhouette and as right ventricular outflow obstruction following myocardial trauma, is presented, along with a review of the English-language literature on delayed postoperative tamponade and loculated pericardial effusion. The importance of a low, fixed cardiac output and nonspecific physical findings in suggesting the clinical diagnosis is emphasized. The absence of many of the classic signs and symptoms of pericardial tamponade is noted, as is the possibility of unusual changes in the appearance or function of the heart in the presence of a loculated effusion. Finally, the differential diagnosis and the results of a variety of diagnostic techniques are discussed.






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Copyright © 1983 by The Society of Thoracic Surgeons.