Q: Why the perforation of proximal ascending aorta can cause cardiac tamponade?
Answer: This is due to the anatomic location of the aortic root and first 10 cm of the ascending aorta, which lies within the pericardium.
This is a surgical emergency. Without an appropriate workup, proceeding to pericadiocentesis just on the basis of echocardiography is not a prudent thing to do. Sole pericardiocentesis should be avoided as it may instantly lead to death due to increase tear of the aorta. Clinical presentation and other radiological findings should be carried out if time permits otherwise emergent call to OR is needed.
#surgical-critical-care
#cardiology
Reference:
1. Guo R, Feng YM, Wan D. Hemorrhagic cardiac tamponade complicated by acute type A aortic dissection: A case report with critical care ultrasound findings. Medicine (Baltimore). 2017;96(49):e8773. doi:10.1097/MD.0000000000008773
2. Ryu, D.W., Lee, M.K. Cardiac tamponade associated with delayed ascending aortic perforation after blunt chest trauma: a case report. BMC Surg 17, 70 (2017). https://doi.org/10.1186/s12893-017-0266-2
No comments:
Post a Comment