"ventricular interdependence" In cardiac tamponade

Q: What is "ventricular interdependence" In cardiac tamponade?

Answer: Distension of one ventricle alters the distensibility and filling pressure of the other

A less-discussed pathophysiology of cardiac tamponade is "ventricular interdependence," also known as "ventricular interaction," which plays an integral role in the decreased filling of the left ventricle during inspiration. As cardiac tamponade progresses, the effective compliance of the cardiac chambers is limited by pericardial stretch. This transmits the right ventricle's (RV) ensuing distension to the interventricular septum and causes the septum to bulge to the left, which is already underfilled due to a tight pericardium. This further reduces left ventricular compliance and exacerbates the reduction in left ventricular filling during inspiration. 

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References:

1. Tiwari S, LeJemtel T, Finn M. Role of ventricular interdependence as an early echocardiographic sign of cardiac surgical postoperative pericardial tamponade. J La State Med Soc. 2012 Nov-Dec;164(6):336-9, 341-2. PMID: 23431677.

2. Mohanan Nair KK, Gopalakrishnan A, Ganapathi S, Harikrishnan S, Valaparambil A, Tharakan J. Arterial Discordance in Cardiac Tamponade. J Invasive Cardiol. 2016 Oct;28(10):E124-E125. PMID: 27705896.

3. Alerhand S, Adrian RJ, Long B, Avila J. Pericardial tamponade: A comprehensive emergency medicine and echocardiography review. Am J Emerg Med. 2022 Aug;58:159-174. doi: 10.1016/j.ajem.2022.05.001. Epub 2022 May 6. PMID: 35696801.