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November 18, 1968

Cardiac Tamponade From CVP Catheter Perforation

Author Affiliations

Massachusetts General Hospital Bosto

JAMA. 1968;206(8):1794-1795. doi:10.1001/jama.1968.03150080074025

To the Editor:—  The monitoring of central venous pressure (CVP) through a catheter has definite value for accurate correction of hypovolemia and assessment of myocardial competence. There are very few reported complications. After subclavian vein catheterization, pneumothorax1 or, less frequently, embolization from a catheter breaking off from an indwelling needle may occur.2 The following case describes a cardiac perforation in an asthmatic patient.

Report of a Case:—  A 26-year-old slender Cuban woman was admitted through the emergency room with extreme shortness of breath and a lifelong history of severe asthma. Her vital signs were pulse, 140 beats per minute; respiration, 48 per minute; and blood pressure, 90/40 mm Hg. The jugular veins were flat in a recumbent position, the trachea was in the midline, and diffuse wheezes and rhonchi were present in the hyperresonant chest. On ausculation, the first heart sound was increased but no murmurs were heard.