Compression of the superior vena cava and right atrium in cardiac tamponade

Stephen W. Miller, Laura Feldman, Igor Palacios, Robert E. Dinsmore, John B. Newell, Linda Gillam, Arthur E. Weyman

Research output: Contribution to journalArticle

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Abstract

In an attempt to identify specific angiographic patterns which might be useful in distinguishing cardiac tamponade from constrictive pericarditis and other causes of right atrial hypertension, we studied the angiographic and hemodynamic characteristics of 10 patients with cardiac tamponade and compared these with similar characteristics in a comparable group of patients with either constrictive pericarditis, effusive-constrictive pericarditis, or pericardial effusion with left ventricular failure. Two predictive angiographic patterns of cardiac tamponade were noted: (1) a tapering or local lateral indentation of the intrapericardial portion of the superior vena cava, and (2) an exaggerated phasic variation in the diameter of the superior vena cava at its junction with the right atrium. Using the ratio of the minimum-to-maximum diameter of the intrapericardial superior vena cava (caval compression ratio), a stepwise logistic regression indicated that when this ratio was < 0.62, cardiac tamponade was present with a sensitivity of 80%, a specificity of 90%, and a p value < 0.001. The change in diameter of the superior vena cava between systole and diastole (phasic narrowing ratio) also was a discriminator of cardiac tamponade (p < 0.04). Two-dimensional echocardiographic studies in an additional group of 10 patients with cardiac tamponade demonstrated marked concavity of the right atrial free wall, which corresponded temporally to the angiographic abnormality, but was even more marked than that noted on the cineangiograms. These results indicate that specific changes can be appreciated on superior vena cavography and can be useful in distinguishing cardiac tamponade from other pericardial or myocardial processes associated with right atrial hypertension.

Original languageEnglish (US)
Pages (from-to)1287-1292
Number of pages6
JournalThe American Journal of Cardiology
Volume50
Issue number6
DOIs
StatePublished - Jan 1 1982
Externally publishedYes

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Cardiac Tamponade
Superior Vena Cava
Heart Atria
Constrictive Pericarditis
Hypertension
Venae Cavae
Diastole
Pericardial Effusion
Systole
Logistic Models
Hemodynamics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Miller, S. W., Feldman, L., Palacios, I., Dinsmore, R. E., Newell, J. B., Gillam, L., & Weyman, A. E. (1982). Compression of the superior vena cava and right atrium in cardiac tamponade. The American Journal of Cardiology, 50(6), 1287-1292. https://doi.org/10.1016/0002-9149(82)90465-9
Miller, Stephen W. ; Feldman, Laura ; Palacios, Igor ; Dinsmore, Robert E. ; Newell, John B. ; Gillam, Linda ; Weyman, Arthur E. / Compression of the superior vena cava and right atrium in cardiac tamponade. In: The American Journal of Cardiology. 1982 ; Vol. 50, No. 6. pp. 1287-1292.
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Miller, SW, Feldman, L, Palacios, I, Dinsmore, RE, Newell, JB, Gillam, L & Weyman, AE 1982, 'Compression of the superior vena cava and right atrium in cardiac tamponade', The American Journal of Cardiology, vol. 50, no. 6, pp. 1287-1292. https://doi.org/10.1016/0002-9149(82)90465-9

Compression of the superior vena cava and right atrium in cardiac tamponade. / Miller, Stephen W.; Feldman, Laura; Palacios, Igor; Dinsmore, Robert E.; Newell, John B.; Gillam, Linda; Weyman, Arthur E.

In: The American Journal of Cardiology, Vol. 50, No. 6, 01.01.1982, p. 1287-1292.

Research output: Contribution to journalArticle

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