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Updated: Jul 13, 2026
08:45
Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
Published on: April 18, 2025
Left ventricular tamponade - a clinical chameleon.
H Möllmann1, A Zirlik, H M Nef
1Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany. h.moellomann@kerchhoff-klinik.de
The Thoracic and Cardiovascular Surgeon
|July 17, 2007
Summary
A patient post-heart surgery developed cardiogenic shock mimicking myocardial infarction. This was actually an isolated left ventricular tamponade, requiring urgent surgical drainage due to its unusual location.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Aortocoronary bypass surgery is a critical intervention for myocardial infarction.
- Post-operative complications can present with diverse and sometimes misleading clinical signs.
Observation:
- A 45-year-old patient developed cardiogenic shock 12 days after aortocoronary bypass surgery.
- Initial symptoms included angina, tachycardia, hypotension, ECG ST-elevations, and positive troponin T.
- Echocardiography suggested pericardial effusion, but classic tamponade signs were absent.
Findings:
- Computed tomography revealed an isolated left ventricular tamponade.
- This condition caused severe diastolic and systolic dysfunction with impaired ventricular filling.
- Percutaneous pericardiocentesis was not feasible due to the atypical localization.
Implications:
- This case highlights that myocardial infarction signs can mask atypical left ventricular tamponade.
- Early and accurate diagnosis is crucial, especially in post-cardiac surgery patients.
- Prompt surgical intervention is vital for managing such complex cases.
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