Cardiac tamponade in association with an atrial septal defect: echocardiographic Doppler and hemodynamic observations

We describe a case of cardiac tamponade in association with an atrial septal defect, in which pulsus paradoxus and respiratory variations in right and left ventricular filling were absent. Doppler echocardiography of the flow across the atrial septal defect showed bidirectional shunting, explaining the absence of pulsus paradoxus and respiratory variations in chamber filling.