Localized right atrial tamponade after aortic valve replacement

: A 78-year-old man developed isolated right atrial tamponade 15 hours following aortic valve replacement. There were excessive postsurgical bleeding, low blood pressure, and low cardiac output. Volume expansion and inotropic therapy did not increase blood pressure. There were no cardiomegaly and echo-free space. Diagnosis was made by appearance of pulsus paradoxus and transthoracic echocardiography and confirmed by surgery. The clinical picture was improved dramatically after surgical removal of the hematoma. Right atrial tamponade leads to a unique clinical conglomeration of hemodynamic and echocardiographic features. Constant attention to this entity is necessary to make a timely diagnosis.