1/6. hypotension due to unexpected cardiac tamponade.We report a case of profound hypotension, after induction of general anaesthesia, that resulted from unexpected cardiac tamponade. The differential diagnosis was complicated by the absence of any evidence to indicate that there was significant direct chest injury. Many of the recognised clinical signs of cardiac tamponade were absent, in particular, there was no compensatory tachycardia, and heart rate remained stable despite severe hypotension before surgical drainage of the pericardium. The possible aetiology and pathophysiology is discussed. It is suggested that after major trauma, cardiac tamponade should be considered as a possibility even in the absence of significantly abnormal cardiovascular signs, evidence of direct chest injury, or an abnormal chest X ray.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/6. dissection of ascending thoracic aorta complicated by cardiac tamponade.Two cases of cardiac tamponade caused by dissections of the ascending thoracic aorta are described. Despite uneventful induction of anaesthesia one patient exsanguinated following sternotomy and release of pericardial tamponade as the resulting increase in blood pressure caused aortic rupture. The second patient was managed with femoral-femoral bypass, propranolol and vasodilators prior to sternotomy to avoid this complication, and he survived. The anaesthetic management of a patient with cardiac tamponade is directed towards maintaining cardiac filling pressures and contractility. When the tamponade is released the sudden increase in cardiac output and blood pressure may cause the already weakened aorta to rupture.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/6. cardiac tamponade complicating anaesthetic induction for repair of ascending aorta dissection.A case is described of a 69-year-old woman with dissection of the ascending aorta who developed cardiac tamponade during induction of anaesthesia. The tamponade was diagnosed by a haemodynamic profile showing approximation of the central venous, pulmonary wedge and pulmonary arterial diastolic pressures, and was treated with rapid surgical intervention and drainage of the haemopericardium. cardiac tamponade and dissecting aneurysms of the ascending aorta are conditions with contrasting anaesthetic considerations and the problems encountered are discussed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/6. Percutaneous balloon pericardiotomy as a therapeutic alternative for cardiac tamponade and recurrent pericardial effusion.A terminally ill patient with cardiac tamponade secondary to metastatic breast cancer was successfully treated by percutaneous balloon pericardiotomy. The procedure was performed through subxiphoid approach under local anaesthesia and its beneficial effect was maintained until the patient's death from her primary disease. A second, 86-year-old, debilitated patient and a third 52-year-old patient were managed likewise and both left hospital relieved from recurrent severe pericardial effusions. The later two patients have shown no signs of recurrence for fifteen and twelve months respectively.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/6. cardiac tamponade after intrapericardial diaphragmatic hernia.An unusual case of intrapericardial diaphragmatic hernia is presented. cardiac tamponade occurred in the operating room soon after induction of anaesthesia. Surgical removal of the herniated omentum and stomach allowed haemodynamic improvement. The pathophysiology is discussed and patients with cardiac tamponade reviewed.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
6/6. Anaesthesia for operation of traumatic heart tamponade. A case report.The authors report a case of myocardial stab wound followed by shock and symptoms of heart tamponade. Following a discussion on the haemodynamic aspects of this disease entity and description of the case the authors analize the most essential elements of general anaesthesia in such conditions.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |