Regional cardiac tamponade: a hemodynamic study.

In 10 dogs, atrial tamponade, ventricular tamponade and then combined atrioventricular (AV) tamponade were produced at 10, 15 and 20 mm Hg intrapericardial pressure. Cardiac output decreased significantly at each level of cardiac tamponade; the changes in cardiac output and mean aortic pressure were comparable with atrial and ventricular tamponade. Combined atrial and ventricular tamponade produced significantly greater increases of right and left atrial pressure and significantly greater decreases of cardiac output than did either atrial or ventricular tamponade. During atrial tamponade only, a significant pressure gradient developed between the venae cavae and the right atrium. Compression of both ventricles by tamponade has a much greater hemodynamic effect than does compression of either ventricle alone. Compression of the entire heart has a greater hemodynamic effect than does compression of the atria alone or the ventricles alone. Compression of the great veins has a potential effect in tamponade, demonstrable when the ventricles could fill normally.