Percutaneous Balloon Pericardiotomy Discussion

Percutaneous Balloon Pericardiotomy Discussion
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Percutaneous Balloon Pericardiotomy Discussion
1 A 61-year old woman with recent tricuspid valve
repair presents with increasing dyspnea, orthopnea,
and presyncope. The patient was hypotensive, with
distended jugular veins, and distant heart sounds
on physical examination. On the basis of the
hemodynamic tracing from the right ventricle (RV)
shown in the following figure, which of the following
statements is incorrect?
(A) Pulsus paradoxus is likely to be present
(B) Presence of right ventricular collapse lasting
more than one third of diastole is a more
sensitive echo finding in this condition than
right atrial collapse
(C) Blunt or absent Y descent on the right atrial
pressure tracing is typically described in this
(D) Ventricular interdependence may be accentuated
2 Cardiac tamponade in the absence of pulsus paradoxus is described with all of the following, except:
(A) Aortic incompetence
(B) Severe rheumatoid spondylitis
(C) Constrictive pericarditis
(D) Large atrial septal defect
3 Regarding the intervention depicted in the figures,
which of the following statements is incorrect?
(A) Left pleural effusion occurs in 1% to 2% of
Percutaneous Balloon Pericardiotomy Discussion
Percutaneous Balloon Pericardiotomy for Patients with Pericardial Effusion and Tamponade 263
(B) A pericardiocutaneous fistula is a potential
(C) It is recommended that the balloon be inflated
until the waist disappears
(D) Biplane fluoroscopy is recommended
4 All of the following are relative contraindications to
percutaneous balloon pericardiotomy, except:
(A) Marginal respiratory reserve
(B) Presence of a large pleural effusion
(C) Thrombocytopenia
(D) Malignant pericardial effusion
Percutaneous Balloon Pericardiotomy Discussion
5 Which of the following catheterization finding most
reliably supports a diagnosis of pericardial constriction over restrictive cardiomyopathy?
(A) Pulmonary artery systolic pressure <50 mm Hg
(B) A prominent Y descent
(C) Equalization of right and left heart late diastolic
(D) Ventricular interdependence
6 Regarding pericardiocentesis, which of the following
statements is most accurate?
(A) It is advisable to drain <500 mL at a time to
avoid acute right ventricular dilatation
(B) Recurrence ratewith drainage of large idiopathic
pericardial effusions is no better than with
conservative management
(C) Major complications occur during 1.3% to 1.6%
of pericardiocenteses
(D) Effusions measured by echo tend to be larger
than those measured by computed tomography
(CT) or magnetic resonance imaging (MRI)
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