Left ventricular cardiac tamponade

Usual manifestation of cardiac tamponade on echocardiography is diastolic collapse of right atrium and right ventricle. This is because right sided chambers can be compressed with much lower intrapericardial pressures than the thicker left ventricle. Isolated left ventricular cardiac tamponade can occur postoperatively due to loculated collections posterior to the left ventricle. Echocardiogram will show left ventricular diastolic compression without associated right ventricular or right atrial collapse. Another situation in which isolated left ventricular diastolic collapse occurring with circumferential pericardial effusion alson with cor pulmonale has been reported [Gollapudi RR et al. Left ventricular cardiac tamponade in the setting of cor pulmonale and circumferential pericardial effusion. Case report and review of the literature. Cardiol Rev. 2005;13:214-7]. In this case, right ventricular collapse was possibly prevented by the severe pulmonary hypertension and right ventricular hypertrophy. The disorder was noted in a case of connective tissue disorder with cor pulmonale. Left ventricular diastolic collapse can significantly affect left ventricular filling and cardiac output. The classic finding of cardiac tamponade – pulsus paradoxus, may be masked in left ventricular tamponade. An interesting case of left ventricular diastolic collapse and regional tamponade following cardiac surgery due to a large left pleural effusion, without any pericardial effusion has also been described [Bilku RS et al. Left ventricular diastolic collapse and late regional cardiac tamponade postcardiac surgery caused by large left pleural effusion. J Am Soc Echocardiogr. 2008;21:978.e9-11]. In this case, tamponade occurred more than two weeks after the surgery, which was an elective aortic valve replacement.