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Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
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Related Experiment Video

Updated: Apr 16, 2026

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
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Paradoxical hemodynamic collapse after subxiphoid pericardial window.

Benita T Liao1, Sansan S Lo

  • 1From the Anesthesiology Department, Columbia University, New York, New York.

A & a Case Reports
|March 17, 2015
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Summary

A patient with cardiac tamponade experienced right heart failure after fluid drainage. Emergent extracorporeal membrane oxygenation (ECMO) was required for resuscitation, highlighting its critical role in cardiovascular collapse.

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Area of Science:

  • Cardiology
  • Cardiothoracic Surgery
  • Critical Care Medicine

Background:

  • A 56-year-old male with coronary artery disease presented with worsening cough, shortness of breath, hypoxemia, and a new lung mass.
  • The patient required emergent subxiphoid pericardial window surgery due to cardiac tamponade.

Observation:

  • Following drainage of 1200 mL of pericardial fluid, the patient acutely decompensated.
  • Transesophageal echocardiogram revealed acutely decompensated right heart failure.

Findings:

  • The patient experienced cardiovascular collapse refractory to high-dose vasopressors.
  • Emergent veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was initiated for successful resuscitation.

Implications:

  • This case underscores the potential for right heart failure after pericardial fluid drainage in cardiac tamponade.
  • It highlights the critical role of VA-ECMO as a life-saving intervention in refractory cardiovascular collapse.
  • Early recognition and management of hemodynamic instability are crucial in patients undergoing procedures for cardiac tamponade.