Author + information
- Received December 18, 1989
- Revision received March 7, 1990
- Accepted March 26, 1990
- Published online August 1, 1990.
- Gurpreet S. Kochar, MD,
- Larry E. Jacobs, MD∗ and
- Morris N. Kotler, MD, FACC
- ↵∗Address for reprints: Larry E. Jacobs, MD, Division of Cardiology, Klein Building, 3rd Floor, Albert Einstein Medical Center, York and Tabor Roads. Philadelphia, Pennsylvania 19141.
Four patients developed hypotension after heart surgery. Hemodynamic measurements revealed elevated right atrial pressure with normal pulmonary capillary wedge pressure. Conventional transthoracic two-dimensional echocardiography was technically suboptimal for detection of pericardial effusion. In each patient transesophageal echocardiography demonstrated significant compression of the right atrium by a localized mass. At reoperation atrial compression by an organized hematoma was found and in each instance successfully drained.
Thus, transesophageal echocardiography is superior to transthoracic echocardiography in evaluating critically ill postoperative hypotensive patients and cm differentiate isolated right atrial tamponade from other causes of hemodynamik deterioration such as prosthetic valve dysfunction or left ventricular systolic dysfunction, or both.
- Received December 18, 1989.
- Revision received March 7, 1990.
- Accepted March 26, 1990.