Hemodynamics of cardiac tamponade during extracorporeal membrane oxygenation support in a patient with fulminant myocarditis

Publication date: Available online 25 October 2018Source: Journal of Cardiology CasesAuthor(s): Toru Kondo, Ryota Morimoto, Tsuyoshi Yokoi, Shogo Yamaguchi, Tasuku Kuwayama, Tomoaki Haga, Hiroaki Hiraiwa, Yuki Sugiura, Naoki Watanabe, Naoaki Kano, Takeo Ichii, Kenji Fukaya, Akinori Sawamura, Takahiro Okumura, Tomo Yoshizumi, Masato Mutsuga, Kazuro Fujimoto, Naoyuki Matsuda, Akihiko Usui, Toyoaki MuroharaAbstractFulminant myocarditis (FM) causes rapid onset severe heart failure requiring inotropes or mechanical circulatory support. Myocarditis is sometimes associated with pericardial effusion, however, how this effusion affects the hemodynamics in patients with FM under venoarterial extracorporeal membrane oxygenation (VA-ECMO) management has not been fully reported. We show a case of FM presenting with cardiac tamponade during VA-ECMO management. A 64-year-old female diagnosed as having FM showed a rapid hemodynamic collapse and that led to the application of VA-ECMO. Although her left ventricular ejection fraction did not improve despite proper hemodynamics management for several days, a pericardial effusion accumulated gradually. Apparent elevation of right atrial pressure and reduction of blood pressure were not observed, however, we performed pericardiocentesis because we were not able to wean off VA-ECMO. After the drainage of pericardial effusion, the blood pressure and cardiac output elevated as did the left ventricular ejection fraction. We successfully removed VA-ECM...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research