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—I am sorry for your misunderstanding of the emphasis of the article. This patient had a massive pericardial effusion and had some evidence of hemodynamic compromise.The pericardiocentesis was performed to improve her overall cardiovascular status. It was not done to determine the efficacy of doing two-dimensional echocardiography simultaneously with the pericardiocentesis. The point that was apparently misunderstood was that simultaneous two-dimensional echocardiography was performed with a clinically and therapeutically indicated pericardiocentesis to determine the efficacy of using the two-dimensional instrument to visualize the pericardiocentesis needle. We clearly did not mean to imply that the pericardiocentesis was indicated to determine the efficacy of using the two-dimensional technique. Just the opposite is true. Furthermore, the published article does convey, by means of the physical description and the evidence of pulsus paradoxus, that the patient did have hemodynamic compromise.I do appreciate your letter. I must assure you that even
Martin RP. Invasive Cardiac Procedures-Reply. Arch Intern Med. 1983;143(9):1830. doi:10.1001/archinte.1983.00350090211046