Transient Systolic Dysfunction after Relief of Cardiac Tamponade

Abstract

Cardiac tamponade is known to directly affect the diastolic function of the myocardium, but no cases have been reported in which systolic function was affected. We describe two patients with malignant pericardial effusions and previously normal left ventricular function in whom marked reductions in left ventricular systolic function developed after the relief of tamponade by pericardiocentesis. The patients received serial follow-up with transthoracic echocardiography, which documented a progressive return to normal systolic function in the absence of further intervening therapy. These two cases suggest that cardiac tamponade may transiently affect systolic function. Potential pathophysiologic mechanisms include changes in coronary blood flow and sympathetic tone induced by tamponade.