Berge K H, Lanier W L, Reeder G S
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1992 Jul;67(7):667-70. doi: 10.1016/s0025-6196(12)60723-x.
Transesophageal echocardiography is a safe, minimally invasive procedure that should be considered when the diagnosis of cardiac tamponade is a possibility and when conventional methods fail to provide conclusive diagnostic information. In this report, we describe a 74-year-old man in the intensive-care unit whose condition was unstable postoperatively because of an occult loculated pericardial effusion and cardiac tamponade. Routine noninvasive and invasive monitoring, including hemodynamic monitoring and transthoracic echocardiography, failed to confirm definitively the suspected diagnosis of cardiac tamponade. In addition, because of the hemodynamic instability of the patient, transporting him for definitive tests (such as fast computed tomographic scanning of the mediastinum, which could not be performed at the bedside) for assessment of cardiac tamponade was relatively contraindicated. In our patient, the diagnostic information obtained by transesophageal echocardiography may have been lifesaving.
经食管超声心动图是一种安全的微创检查方法，当有可能诊断为心脏压塞且传统方法未能提供确凿诊断信息时，应考虑采用该方法。在本报告中，我们描述了一名74岁的重症监护病房患者，其术后因隐匿性局限性心包积液和心脏压塞而病情不稳定。包括血流动力学监测和经胸超声心动图在内的常规非侵入性和侵入性监测均未能明确证实疑似心脏压塞的诊断。此外，由于患者血流动力学不稳定，将其转运至进行确定性检查（如不能在床边进行的纵隔快速计算机断层扫描）以评估心脏压塞相对禁忌。在我们的患者中，经食管超声心动图获得的诊断信息可能挽救了生命。
