Highlights the utility of Swan-Ganz catheterization and multimodality imaging in diagnosing delayed, localized post-cardiac-surgery tamponade when initial echocardiography is unhelpful.
May prompt multimodality evaluation including catheterization for suspected localized post-surgical tamponade when initial echocardiography is unrevealing; leaves open broader diagnostic algorithms.
A patient with dyspnea and lethargy 19 days after aortic valve replacement was admitted to the hospital with physical signs suggesting cardiac tamponade. Initial echocardiogram was unhelpful, but Swan‐Ganz catheterizatlon showed a gradient in diastole between the right atrium and ventricle. Anglography and repeat echocardlography then showed a mass compressing the right atrium, which was confirmed at surgery.
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Marx et al. (1981) studied this question.
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