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Cardiac Tamponade

Brian M. Salata, MD, MS and Parag Goyal, MD, MSc Reviewed 06/2018
 


BASICS

DESCRIPTION

  • An accumulation of fluid within the pericardium that causes compression of the chambers of the heart, impairing diastolic filling, reducing cardiac output, and ultimately leading to ...

DIAGNOSIS

HISTORY

  • Dyspnea: most sensitive symptom (88%) (1)[A]

  • Vague chest pain or an overall subjective sense of discomfort

  • Syncope or presyncopal symptoms

  • Altered mentation from poor perfusion

  • Nausea or ...

TREATMENT

GENERAL MEASURES

Maintain hemodynamic stability until definitive drainage, ICU monitoring; may consider Swan-Ganz catheter if time allows 

MEDICATION

First Line

Fluid resuscitation 
  • Fluid bolus w...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Follow-up echocardiogram may be used to evaluate for recurrence of effusions. 

PROGNOSIS

Acute traumatic tamponade: 70–80% survival rate at level 1 trauma centers 

COMPLICATIONS

REFERENCES

Shyy W, Knight RS, Kornblith A, et al. Point-of-care diagnosis of cardiac tamponade identification by the flow velocity paradoxus. J Ultrasound Med.  2017;2197–2201.  [View Abstract]
...

ADDITIONAL READING

Grecu L. Cardiac tamponade. Int Anesthesiol Clin.  2012;50(2):59–77. 

CODES

ICD10

I31.4 Cardiac tamponade 

ICD9

423.3 Cardiac tamponade 

SNOMED

35304003 Cardiac tamponade (disorder) 

CLINICAL PEARLS

  • Cardiac tamponade is a potentially reversible cause of pulseless electrical activity.

  • Checking for pulsus paradoxus may be a useful bedside maneuver with reasonable sensitivity in most ...

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