Cardiac Tamponade Flashcards
How much fluid can the pericardium hold before resulting in tamponade?
200 mL if rapid vs up to 2000 mL if slowly accumulated
Pericardial effusion versus cardiac Tampanode?
Fluid in the pericardial space versus fluid in the pericardial space that compresses the heart and impedes diastolic filling
Beck Triad?
Signs of rapid cardiac tamponade
- Hypotension
- elevated jugular venous pressure, 3. small quiet heart
Clinical picture of slow cardiac tamponade?
- Dyspnea
- Elevated jugular pressure
- Peripheral edema
- Cardiomegaly on x-ray
- Pulsus paradoxus
Pulsus paradoxes?
Dropp in systolic blood pressure during inspiration by 10+ mm Hg
Pulsus paradoxes seen in these pathologies?
- Cardiac tamponade
2. Disturbed intrathoracic pressures during respiration (COPD)
Causes of constrictive pericarditis?
- TB/Viral infections
- Radiation therapy
- Cardiac surgery
- Uremia
- Malignancy
Difference between cardiac tamponade and constrictive pericarditis?
No pulses paradoxes in constructive pericarditis
Kussmaul sign?
Increase in JVP during inspiration seen in constrictive pericarditis (Normally blood would be sucked into the heart, but because of diastolic restriction, blood fills jugular vein)
Pericardial knock?
High-pitched early diastolic sound occurring just after aortic valve closure. Seen in pericarditis
Restrictive cardiomyopathies with elongated PR interval?
Amyloidosis, sarcoidosis, hemochromatosis
Endomyocardial fibrosis?
Fibrosis of the endocardium along with fever and eosinophilia (25% of deaths to heart dz in Africa)
Imaging that could potentially differentiate between constrictive pericarditis and restrictive cardiomyopathy?
MRI, but more likely need biopsy
ECG shows ST segment elevation with low voltage diffusely?
Acute pericarditis
Treatment of cardiac Tamponade?
Pericardiocentesis or surgical pericardial window
