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J. Donald Hill, MD; David C. Johnson, FRACS; George E. Miller, Jr., MD; William J. Kerth, MD; Frank Gerbode, MD

AMA Arch Surg. 1969;99(6):808-814.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Postoperative cardiac tamponade due to mediastinal blood clot or fluid under tension may remain latent for some days after open heart surgery. The initial clinical state frequently masquerades as a state of refractory congestive cardiac failure or a mild low cardiac output syndrome producing mental disorientation. When severe tamponade eventuates there is an extreme surgical emergency, but as one to two weeks may have elapsed since surgery the significance is often missed.

The classical picture of tamponade due to pericardial fluid as described by Stewart et al¹ may occur, but usually there is mediastinal tamponade similar to the acute traumatic mediastinal hematomata described by Endress² and Al-Naaman,³ or an encysted collection of clot about the heart producing local compression of one or more cardiac chambers.⁴

This paper describes seven cases of latent tamponade at Pacific Medical Center which have been instructive in avoiding errors in diagnosis . . . [Full Text PDF of this Article]

Author Affiliations
San Francisco

From the departments of cardiovascular surgery, Presbyterian Hospital, and the Heart Research Institute, Institute of Medical Sciences, Pacific Medical Center, San Francisco.

Footnotes
Submitted for publication Aug 5, 1969.

Read before the 17th scientific meeting of the North American Chapter of the International Cardiovascular Society, New York, July 12, 1969.

Reprint requests to Department of Cardiovascular Surgery and Heart Research Institute, Pacific Medical Center, San Francisco 94115 (Dr. Hill).

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