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(Chest. 1971;59:312-315.)
© 1971 American College of Chest Physicians

Objective Assessment of Pericardial Tamponade; Right Heart Catheterization at the Bedside

Sidney J. Fillmore M.D.1; Stephen Scheidt M.D.1; and Thomas Killip M.D.2

1 Division of Cardiology, Department of Medicine, The New York Hospital-Cornell Medical Center, New York, New York
2 Roland Harriman Professor of Medicine, Cornell University Medical College

A technique is described for rapidly obtaining right ventricular pressure pulses at the bedside of the critically ill patient in whom pericardial tamponade is clinically suspected. A delicate flexible nylon catheter is introduced into the venous system and advanced centrally. Constant monitoring of pressure pulses signals cannulation of the right ventricle. Clinically suspected tamponade can be confirmed or rejected by analysis of the pressure pulse contour and the ratio of systolic to diastolic pressure. This technique has proved useful in helping us to decide whether or not to perform pericardiocentesis. Several unnecessary pericardiocenteses have been avoided. Illustrative cases are included.




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