13. Cardiac Tamponade

Question 1

Cardiac Tamponade Etiologies

Answer 1

Surgical-related cause (post-op cardiac sx), medical related cause (pericarditis, pericardial effusion), trauma

Question 2

Signs/symptoms of cardiac tamponade

Answer 2

-Restlessness and agitation
-Hypotension
-Increased JVD
-Equalization of CVP, pulmonary artery diastolic pressure, and PAOP
-Muffled heart sounds
-Enlarging cardiac silhouette and mediastinum on chest radiograph
**Narrowed pulse pressure (i.e. 82/68)
**Pulsus Paradoxus: an excessive drop (greater than 12 mmHg) in the SBP during inspiration, which is the result of cardiac muscle restriction caused by the tamponade with inspiration; the intrathoracic pressure increases, and the venous return decreases
-Best seen on an arterial waveform as respiratory variation