naa a22 4500 510744125 CHVBK 20180411083039.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12630-013-9968-9 doi (NATIONALLICENCE)springer-10.1007/s12630-013-9968-9 Unrecognized tamponade diagnosed pre-induction by focused echocardiography [Elektronische Daten] [Rebecca Gerlach, Tarit Saha, Rene Allard, Rob Tanzola] Une échocardiographie ciblée permet de diagnostiquer une tamponnade non reconnue avant l'induction Purpose: We report a case of unrecognized cardiac tamponade diagnosed pre-induction by focused transthoracic echocardiography (TTE). The value of focused perioperative TTE, the anesthetic implications of Churg-Strauss syndrome, and the diagnosis of cardiac tamponade are discussed. Clinical features: A 58-yr-old man with a history of severe asymptomatic aortic stenosis presented for elective endoscopic sinus surgery for intractable nasal polyps with recurrent sinusitis. His cardiologist and cardiac surgeon had recommended proceeding with surgery, as aortic valve replacement was not indicated because he was asymptomatic. Prior to induction, a focused TTE was performed by anesthesia in order to document the degree of aortic stenosis, baseline ventricular function, and baseline volume status. This provided a baseline for comparison in case the patient's hemodynamic status should deteriorate intraoperatively. Unexpectedly, the TTE examination revealed cardiac tamponade. After confirmation of the diagnosis by cardiology, urgent pericardiocentesis was performed. A diagnosis of Churg-Strauss syndrome was ultimately made, and the patient was treated with high-dose prednisone therapy. Conclusion: Focused TTE has significant clinical utility for the diagnosis and assessment of hemodynamically significant cardiac conditions, particularly in the complex patient where clinical examination is challenging and echocardiographic findings can have immediate management implications. Canadian Anesthesiologists' Society, 2013 Gerlach Rebecca Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut Saha Tarit Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut Allard Rene Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut Tanzola Rob Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/8(2013-08-01), 803-807 0832-610X 60:8<803 2013 60 12630 https://doi.org/10.1007/s12630-013-9968-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12630-013-9968-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gerlach Rebecca Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut NATIONALLICENCE 700 1- Saha Tarit Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut NATIONALLICENCE 700 1- Allard Rene Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut NATIONALLICENCE 700 1- Tanzola Rob Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, ON, Canada aut NATIONALLICENCE 773 0- Canadian Journal of Anesthesia/Journal canadien d'anesthésie Springer US; http://www.springer-ny.com 60/8(2013-08-01), 803-807 0832-610X 60:8<803 2013 60 12630 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer