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Editorials |

Pericardiocentesis : Blind No More!

Susan M. Fagan, MD; Kwan-Leung Chan, MD (Ottawa, Canada)
Author and Funding Information

Dr. Fagan is a Fellow in Echocardiography at the University of Ottawa Heart Institute. Dr. Chan is Professor of Medicine at the University of Ottawa Heart Institute.

Correspondence to: Kwan-Leung Chan, MD, University of Ottawa Heart Institute, 40 Ruskin St, Ottawa, Ontario, K1Y4W7; e-mail: kchan@ottawaheart.ca



Chest. 1999;116(2):275-276. doi:10.1378/chest.116.2.275
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Extract

Cardiac tamponade is a life-threatening condition that requires prompt diagnosis and management. Historically, the diagnosis of cardiac tamponade has been based on clinical findings. The classic triad of falling blood pressure, elevated systemic venous pressure, and quiet heart sounds is applicable mainly in the setting of acute onset of tamponade secondary to intrapericardial hemorrhage.1 These findings lack specificity, particularly in the patients who develop cardiac tamponade following cardiothoracic surgery. In this group of patients, other more common conditions such as left ventricular dysfunction can give rise to the same findings. The limitations of the clinical findings were confirmed in the study by Tsang et al in this issue of CHEST (see page 322). They examined the clinical and echocardiographic characteristics of significant pericardial effusions following cardiothoracic surgery at the Mayo Clinic over an 11-year period. The estimated incidence was 0.8%, with the highest incidence in heart transplant (8.4%) and the lowest in isolated coronary bypass surgery (0.2%). Anticoagulant use in 68% of these patients was the most common predisposing factor.


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