Cardiac Tamponade

Question 1

Causes

Answer 1

Iatrogenic (e.g. after PCI) Trauma Malignancy Pericarditis Aortic dissection AMI Uraemia

Question 2

Pathophysiology

Answer 2

Rapid pericardial effusion resulting in compression of the heart. Reduced filling results in reduced output, causing obstructive shock and death

Question 3

Clinical Presentation

Answer 3

Beck’s triad - Raised JVP, hypotension, muffled heart sounds Chest pain Cough Dyspnoea Pericardial friction rub Narrow pulse pressure Pulsus paradoxus

Question 4

ECG

Answer 4

Low QRS voltage T wave changes Electric alternans

Question 5

Investigations

Answer 5

Echo Right heart catheterisation

Question 6

Acute Management

Answer 6

Pericardiocentesis - MCS