2006 Volume 13 Issue 3 Pages 235-238
We report a case of localized right atrial tamponade due to a giant hematoma after cardiac surgery. A 70-year-old man had coronary artery bypass surgery for angina pectoris. On postoperative day 9, severe hypotension occurred. Palliative infusion therapy was instituted due to hypovolemia as diagnosed by transthoracic echocardiography. On postoperative day 10, chest X-ray demonstrated cardiomegaly and transthoracic echocardiography revealed a small amount of pericardial effusion. A pericardiocentesis was immediately performed, however, there was no significant hemodynamic improvement. Transesophageal echocardiography identified localized right atrial tamponade due to a large pericardial hematoma compressing the right atrium. The clinical picture was improved dramatically after surgical removal of the blood clots. Localized right atrial tamponade must be kept in mind as a cause of shock following coronary artery bypass surgery. Transesophageal echocardiography should be performed if transthoracic echocardiography is not helpful.
