小林 賀奈子¹, 田辺 一明¹, 佐野 和也¹, 北村 順¹, 木下 順久¹, 浅沼 俊彦¹, 吉冨 裕之¹, 島田 俊夫¹, 村上 林児²

Kanako KOBAYASHI¹, Kazuaki TANABE¹, Kazuya SANO¹, Jun KITAMURA¹, Yoshihisa KINOSHITA¹, Toshihiko ASANUMA¹, Hiroyuki YOSHITOMI¹, Toshio SHIMADA¹, Rinji MURAKAMI²

¹島根医科大学第4内科, ²島根医科大学救急部

¹Fourth Department of Internal Medicine, Shimane Medical University, ²Emergency Unit, Shimane Medical University

キーワード : Cardiac surgery, Cardiac tamponade, Echocardiography, Left ventricle, Pericardial effusion

Late cardiac tamponade following open-heart surgery is a potentially lethal complication that is often difficult to diagnose. A 75-year-old woman had cardiac tamponade accompanied by left ventricular diastolic collapse caused by loculated pericardial effusion, which appeared 3 years after aortic valve replacement. The patient made a remarkable recovery from cardiac tamponade after 200 ml of bloody fluid was drained by pericardiocentesis. Recurrence of the pericardial effusion was treated with prednisolone at an initial daily dosage of 40 mg; this was tapered by 10 mg every week. Prednisolone appears to prevent recurrence of pericardial effusion. Left ventricular diastolic collapse may be a useful marker of tamponade in postoperative patients.