Key result
Wearable carotid Doppler tracks ~15% increase in carotid flow time following pericardiocentesis.
Why the study?
Pericardial tamponade diagnosis can be aided by demonstrating the hemodynamic consequences of the effusion using noninvasive tools.
Can a wearable noninvasive carotid Doppler device aid in diagnosing and monitoring the hemodynamic impact of pericardial tamponade before and after pericardiocentesis?
Case Report (n=1)
Can a wearable noninvasive carotid Doppler device aid in diagnosing and monitoring the hemodynamic impact of pericardial tamponade before and after pericardiocentesis?
Effect estimate: +15% change
Absolute Event Rate: 326% vs 277%
A noninvasive wearable carotid Doppler device successfully quantified hemodynamic compromise and real-time recovery in a patient with pericardial tamponade undergoing pericardiocentesis.
Wearable carotid Doppler may track tamponade recovery in select cases; leaves open need for prospective validation before clinical use.
Pericardial tamponade can often be diagnosed through clinical findings and echocardiography; however, the diagnosis can be aided by demonstrating the hemodynamic consequences of the effusion. We describe the use of a wearable carotid Doppler device to help diagnose and monitor pericardial tamponade. CASE SUMMARY: A 54-year-old man developed hypotension after an endobronchial biopsy for a lung mass. Echocardiography showed a pericardial effusion with sonographic evidence of tamponade. A wearable carotid Doppler device demonstrated low corrected carotid flow time (CFT) (a surrogate for stroke volume) with significant respiratory variation, supporting the diagnosis of tamponade. The patient underwent pericardiocentesis which revealed purulent pericardial fluid from a mediastinal abscess. After drainage there was increased CFT and reduced respiratory variability in Doppler, surrogates of improved stroke volume. CONCLUSION: A wearable carotid Doppler device is a noninvasive tool that can help determine the hemodynamic impact of a pericardial effusion, and potentially aid in the diagnosis of pericardial tamponade.
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Prager et al. (2023) conducted a case report in Pericardial tamponade (n=1). Wearable carotid Doppler device (Flopatch) vs. Pre-pericardiocentesis (baseline) was evaluated on Corrected carotid flow time (CFT) as a surrogate for stroke volume (+15% change). The wearable carotid Doppler device demonstrated a 15% increase in corrected carotid flow time (CFT) and marked reductions in respiratory variation following pericardiocentesis.
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