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Nishi T, Shibayama K, Tabata M, et al. A case of right ventricular diastolic dysfunction due to a large hematoma posterior to the left ventricle. J Cardiol Cases. 2015;12(1):8-11doi: 10.1016/j.jccase.2015.02.007.
Nishi, T., Shibayama, K., Tabata, M., Kamio, T., Noguchi, M., Okumura, H., Kawano, Y., Nakatsuka, D., Hiraiwa, N., Obunai, K., Kobayashi, Y., & Watanabe, H. (2015). A case of right ventricular diastolic dysfunction due to a large hematoma posterior to the left ventricle. Journal of cardiology cases, 12(1), 8-11. https://doi.org/10.1016/j.jccase.2015.02.007
Nishi, Tomoko, et al. "A case of right ventricular diastolic dysfunction due to a large hematoma posterior to the left ventricle." Journal of cardiology cases vol. 12,1 (2015): 8-11. doi: https://doi.org/10.1016/j.jccase.2015.02.007
Nishi T, Shibayama K, Tabata M, Kamio T, Noguchi M, Okumura H, Kawano Y, Nakatsuka D, Hiraiwa N, Obunai K, Kobayashi Y, Watanabe H. A case of right ventricular diastolic dysfunction due to a large hematoma posterior to the left ventricle. J Cardiol Cases. 2015 Mar 21;12(1):8-11. doi: 10.1016/j.jccase.2015.02.007. eCollection 2015 Jul. PMID: 30534268; PMCID: PMC6279639.
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J Cardiol Cases. 2015 Mar 21;12(1):8-11. doi: 10.1016/j.jccase.2015.02.007. eCollection 2015 Jul.

A case of right ventricular diastolic dysfunction due to a large hematoma posterior to the left ventricle.

Journal of cardiology cases

Tomoko Nishi, Kentaro Shibayama, Minoru Tabata, Takahiro Kamio, Masahiko Noguchi, Hiroshi Okumura, Yuji Kawano, Daisuke Nakatsuka, Nobuhiko Hiraiwa, Kotaro Obunai, Yoshio Kobayashi, Hiroyuki Watanabe

Affiliations

  1. Tokyo Bay Urayasu Ichikawa Medical Center, Cardiovascular Medicine, Urayasu, Japan.
  2. Tokyo Bay Urayasu Ichikawa Medical Center, Cardiovascular Surgery, Urayasu, Japan.
  3. Department of Cardiovascular Medicine Chiba University Graduate School of Medicine, Chiba, Japan.

PMID: 30534268 PMCID: PMC6279639 DOI: 10.1016/j.jccase.2015.02.007

Abstract

We report a case of right ventricular (RV) diastolic dysfunction due to a large hematoma posterior to the left ventricle (LV) after cardiac surgery. An 80-year-old woman underwent cardiac surgery. After surgery, her physical findings revealed right heart failure. Localized hematoma posterior to the pericardial space and the RV compression to the sternum were shown by computed tomography. Transthoracic Doppler echocardiography demonstrated restrictive physiology of the RV although there was no evidence of constrictive pericarditis. These findings suggest that RV diastolic dysfunction could have occurred due to the hematoma posterior to the LV. Since pleural effusion had persisted despite medical therapy, the hematoma was removed surgically. Soon after surgery, dyspnea and pretibial edema were diminished; bilateral pleural effusion dramatically disappeared. RV diastolic dysfunction estimated by echocardiography was improved and RV compression disappeared. We speculate that there are two physiological mechanisms for the RV compression: (1) the localized hematoma elevated the intrapericardial pressure and (2) the hematoma shifted the entire heart to the sternum. In conclusion, this is the first case report of RV diastolic dysfunction due to large hematoma posterior to the LV. <

Keywords: Localized hematoma; Regional tamponade; Right ventricular diastolic dysfunction

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