PMID- 30693054
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1878-5409 (Electronic)
IS  - 1878-5409 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Jan
TI  - Hemodynamics of cardiac tamponade during extracorporeal membrane oxygenation 
      support in a patient with fulminant myocarditis.
PG  - 22-24
LID - 10.1016/j.jccase.2018.08.009 [doi]
AB  - Fulminant myocarditis (FM) causes rapid onset severe heart failure requiring 
      inotropes or mechanical circulatory support. Myocarditis is sometimes associated 
      with pericardial effusion, however, how this effusion affects the hemodynamics in 
      patients with FM under venoarterial extracorporeal membrane oxygenation (VA-ECMO) 
      management has not been fully reported. We show a case of FM presenting with 
      cardiac tamponade during VA-ECMO management. A 64-year-old female diagnosed as 
      having FM showed a rapid hemodynamic collapse and that led to the application of 
      VA-ECMO. Although her left ventricular ejection fraction did not improve despite 
      proper hemodynamics management for several days, a pericardial effusion 
      accumulated gradually. Apparent elevation of right atrial pressure and reduction 
      of blood pressure were not observed, however, we performed pericardiocentesis 
      because we were not able to wean off VA-ECMO. After the drainage of pericardial 
      effusion, the blood pressure and cardiac output elevated as did the left 
      ventricular ejection fraction. We successfully removed VA-ECMO and the patient 
      was discharged without any complications. This is a case report in which a 
      cardiac tamponade under VA-ECMO did not show typical signs and pericardiocentesis 
      contributed to withdrawal of a VA-ECMO system. <Learning objective: Typical 
      findings of cardiac tamponade are less likely to appear in patients with 
      fulminant myocarditis under venoarterial extracorporeal membrane oxygenation 
      management (VA-ECMO). Drainage of pericardial effusion delivers dramatic 
      improvement in blood pressure, cardiac output, and left ventricular ejection 
      fraction. When VA-ECMO cannot be weaned off, pericardiocentesis should be 
      considered in patients with fulminant myocarditis who showed gradual accumulation 
      of pericardial effusion.>.
FAU - Kondo, Toru
AU  - Kondo T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Morimoto, Ryota
AU  - Morimoto R
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Yokoi, Tsuyoshi
AU  - Yokoi T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Yamaguchi, Shogo
AU  - Yamaguchi S
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Kuwayama, Tasuku
AU  - Kuwayama T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Haga, Tomoaki
AU  - Haga T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Hiraiwa, Hiroaki
AU  - Hiraiwa H
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Sugiura, Yuki
AU  - Sugiura Y
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Watanabe, Naoki
AU  - Watanabe N
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Kano, Naoaki
AU  - Kano N
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Ichii, Takeo
AU  - Ichii T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Fukaya, Kenji
AU  - Fukaya K
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Sawamura, Akinori
AU  - Sawamura A
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Okumura, Takahiro
AU  - Okumura T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
FAU - Yoshizumi, Tomo
AU  - Yoshizumi T
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Mutsuga, Masato
AU  - Mutsuga M
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Fujimoto, Kazuro
AU  - Fujimoto K
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Matsuda, Naoyuki
AU  - Matsuda N
AD  - Emergency and Critical Care Medicine, Nagoya University Graduate School of 
      Medicine, Nagoya, Japan.
FAU - Usui, Akihiko
AU  - Usui A
AD  - Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 
      Nagoya, Japan.
FAU - Murohara, Toyoaki
AU  - Murohara T
AD  - Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, 
      Japan.
LA  - eng
PT  - Case Reports
DEP - 20181025
PL  - Japan
TA  - J Cardiol Cases
JT  - Journal of cardiology cases
JID - 101549579
PMC - PMC6342684
OTO - NOTNLM
OT  - Cardiac tamponade
OT  - Extracorporeal membrane oxygenation
OT  - Myocarditis
EDAT- 2019/01/30 06:00
MHDA- 2019/01/30 06:01
PMCR- 2018/10/25
CRDT- 2019/01/30 06:00
PHST- 2018/05/22 00:00 [received]
PHST- 2018/08/21 00:00 [revised]
PHST- 2018/08/27 00:00 [accepted]
PHST- 2019/01/30 06:00 [entrez]
PHST- 2019/01/30 06:00 [pubmed]
PHST- 2019/01/30 06:01 [medline]
PHST- 2018/10/25 00:00 [pmc-release]
AID - S1878-5409(18)30085-9 [pii]
AID - 10.1016/j.jccase.2018.08.009 [doi]
PST - epublish
SO  - J Cardiol Cases. 2018 Oct 25;19(1):22-24. doi: 10.1016/j.jccase.2018.08.009. 
      eCollection 2019 Jan.