Circulation, Vol 52, 460-465, Copyright © 1975 by American Heart Association
IA D'Cruz, HC Cohen, R Prabhu and G Glick
The echocardiographic findings in three patients who presented with
pericardial effusion and cardiac tamponade are described. Cyclic
respiratory changes affected the diastolic movement of the anterior mitral
leaflet, viz., during inspiration its anterior excursion decreased in
amplitude and the E-F slope diminished. This inspiratory alteration in
mitral valve motion was accompanied by an increase in right ventricular
dimensions and a reciprocal decrease in left ventricular dimensions.
Pericardial paracentesis confirmed the presence of effusion and relieved
cardiac tamponade in all the patients. Repeat echocardiography, performed
in two of the patients immediately after the pericardial tap, showed that
the E-F slope had become steeper and that phasic respiratory variations in
the diastolic motion of the anterior mitral leaflet were no longer present.
The compatibility of our observations with the theories which endeavor to
explain the mechanism of the paradoxical pulse in pericardial effusion with
cardiac tamponade is discussed. We suggest that the abnormalities in
anterior mitral leaflet motion defined by echocardiography constitute a
useful addition to the study of patients with suspected cardiac tamponade
resulting from pericardial effusion.
ARTICLES
Diagnosis of cardiac tamponade by echocardiography: changes in mitral valve motion and ventricular dimensions, with special reference to paradoxical pulse
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