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Cardiac tamponade without demonstrable pulsus paradoxus in haemodialysis patients

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Cardiac tamponade is the most sinister complication of pericarditis and occurs in up to 20% of cases of dialysis pericarditis. A unique aspect of the haemodynamics of tamponade and chronic renal disease is the occasional absence of pulsus paradoxus, a sign thought to be universally present with tamponade.

We report 3 episodes of cardiac tamponade which occurred in 2 adequately dialysed patients where absence of detectable pulsus paradoxus led to a delay in the performance of life saving pericardiocentesis. In both patients, preexiting left ventricular dysfunction was felt to be responsible for the absence of this classic sign of tamponade.

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Watson, A.J.S., Finn, M.M.R. & Keogh, J.A.B. Cardiac tamponade without demonstrable pulsus paradoxus in haemodialysis patients. I.J.M.S. 150, 78 (1981).

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  • Pericardial Effusion
  • Pericarditis
  • Cardiac Tamponade
  • Chronic Renal Disease
  • Ultrasonic Examination