PMC3623122_01
Axial noncontrast CT image of the thorax showing the heart with pericardial effusion.
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fig1
This is a case of a 68-year-old male with a history significant for rheumatoid arthritis and a moderate pericardial effusion discovered incidentally on a CT scan of his chest during the initial workup for worsening dyspnea (Figure 1).
Hemodynamics noted during the right heart catheterization. (a) Elevated right atrial (RA) pressure showing respiratory variations. (b) Elevated RA pressure despite decreased pericardial space (PS) pressure immediately after evacuation of pericardial fluid. (c) Elevated RA pressure despite full evacuation of fluid.
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fig2
Despite this extracardiac change in pressure, there were no changes in the intracardiac pressures (Figure 2).
Hemodynamics during right heart catheterization showing persistence ventricular interdependence between the left ventricle (LV) and the right ventricle (RV) after evacuation of pericardial fluid.
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fig3
Right atrial pressure tracings now demonstrated a blunted X descent and rapid Y descent (Figure 3).