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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Irreversible hypotension with subsequent cardiovascular collapse has been reported as a catastrophic complication of inappropriate pneumatic antishock garment (PASG) deflation. This study was undertaken to analyze the cardiodynamic response by which PASG deflation produces hypotension. Five normovolemic patients undergoing cardiac catheterization for atypical chest pain syndrome volunteered for this study. Serial measurements of right atrial, right ventricular, pulmonary artery, left ventricular, and aortic pressures were obtained with subjects supine at the following times: prior to inflation of the PASG; during PASG inflation at 100 mm Hg; and during rapid PASG deflation. Pulmonary and aortic flow velocities were recorded in two patients. The application of external pressure with PASG produced a significant increase in left and right heart pressures (P less than .05). Sudden PASG deflation produced significant transient hypotensive changes (P less than .01). When PASG deflation hemodynamics were compared to preinflation data, mean arterial pressure decreased 14 mm Hg (P less than .01); mean pulmonary pressure decreased 6 mm Hg (P less than .01); and mean right atrial and left ventricular end-diastolic pressures decreased 4 and 6 mm Hg, respectively (P less than .01). An analysis of right and left heart hemodynamic data suggests that the early hypotensive response associated with PASG deflation is consistent with a reduction in left ventricular afterload followed by a decrease in preload.
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PMID:Hemodynamic response to rapid pneumatic antishock garment deflation. 374 May 73

Rupture of the left-ventricular free wall may not always result in immediate irreversible hemodynamic collapse. We report a series of five patients (4 male, 1 female; age 59-79 years) successfully operated for postinfarction free-wall rupture with good long-term results. Two patients presented with syncopy and acute tamponade three days after an acute myocardial infarction. In two patients with atypical chest pain and congestive heart failure, a large pericardial effusion and an extreme localized thinning of a myocardial scar region was seen several weeks after an uncomplicated myocardial infarct. In one patient a pseudoaneurysm was detected, which developed asymptomatically within three weeks after a posterior myocardial infarct. In all cases myocardial rupture was suspected after an echocardiographic examination. At surgery a hemopericardium and a localized rupture site were found. The surgical procedure included closure of the defect by direct suture or patch, CABG in 3 cases, and mitral valve replacement in one patient. The postoperative course was uneventful, only one patient needed IABP for 24 hours. Three patients returned to NYHA functional class I, one patient to class II, and one patient to class III. The latter patient died of heart failure 17 months postoperatively, and the other patients are still alive 4,18,24, and 26 months postoperatively. Thus clinical representation of left-ventricular free-wall rupture after myocardial infarction can be highly variable. But close cooperation between experienced echocardiographers and surgeons may allow successful corrections with good long term-results.
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PMID:Clinical presentation of rupture of the left-ventricular free wall after myocardial infarction: report of five cases with successful surgical repair. 878 31

Pericardial effusion is a common disorder associated with a variety of medical disorders. Diagnostic methods of choice include echocardiography, CT, and MRI. However, diagnosing pericardial effusion with radionuclides is uncommon. A pericardial effusion under pressure may result in tamponade and hemodynamic compromise, which constitutes a cardiac emergency, necessitating emergency intervention with pericardiocentesis or pericardiotomy. Presented is an unusual case of a patient who was referred to the nuclear cardiology laboratory for evaluation of atypical chest pain using stress and rest Tc-99m sestamibi perfusion SPECT. The patient had a large pericardial effusion evident on planar projection images and tomograms. From the gated perfusion study, the authors were able to evaluate left and right ventricular function and to exclude cardiac tamponade because there was no evidence of diastolic collapse of the right ventricle.
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PMID:Diagnosis of pericardial effusion and its effects on ventricular function using gated Tc-99m sestamibi perfusion SPECT. 961 21

A 65-year-old woman presented with a history of dyspnea and atypical chest pain. She was diagnosed with a non-ST-segment elevation myocardial infarction due to a giant right coronary artery aneurysm. After a failed percutaneous embolization, she was scheduled for right coronary artery aneurysm resection, posterior descending artery revascularization and mitral valve repair. During the induction of anesthesia and institution of mechanical ventilation, the patient suffered cardiovascular collapse. The transesophageal echocardiographic examination revealed tamponade physiology owing to compression of the cardiac chambers by the unruptured aneurysm, which resolved with the sternotomy. The surgery was carried out uneventfully.
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PMID:Giant right coronary artery aneurysm with unusual physiology: role of intraoperative transesophageal echocardiography. 2277 20