John P.R. Moore, MBChB, MRCS, John F. Fraser, MRCP, FJFICM

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Presentation transcript:

Outside the Box: Extra-Pericardial Tamponade Due to Acute Recurrence of Hiatus Hernia John P.R. Moore, MBChB, MRCS, John F. Fraser, MRCP, FJFICM The Annals of Thoracic Surgery Volume 89, Issue 5, Pages 1654-1656 (May 2010) DOI: 10.1016/j.athoracsur.2009.09.040 Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Patient monitoring strip. (A) Arterial pressure drop of 20 mm Hg on inspiration. (B) High venous pressures of up to 20 mm Hg. (C) Profound venous pressure drop on inspiration. (D) Pronounced a wave and x-descent suggesting forward venous flow in systole only. (E) Flat y-descent due to poor ventricular diastolic filling. (F) Reproduction of arterial pressure on pulse oximeter trace. The Annals of Thoracic Surgery 2010 89, 1654-1656DOI: (10.1016/j.athoracsur.2009.09.040) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Coronal computed tomograph of chest showing (A) compressed right atrium. (B) Small bowel hiatus hernia. (C) Hiatal diaphragmatic defect. The Annals of Thoracic Surgery 2010 89, 1654-1656DOI: (10.1016/j.athoracsur.2009.09.040) Copyright © 2010 The Society of Thoracic Surgeons Terms and Conditions