Cardiac Tamponade Flashcards
What is cardiac tamponade?
A pericardial effusion that raises intrapericardial pressure reducing ventricular pressure and thus dropping cardiac output
What is the major concern with a tamponade?
It can rapidly lead to a cardiac arrest
What are the causes of tamponade?
Any cause of pericarditis, aortic dissection, trauma, warfarin
What are the clinical features of tamponade?
Increased HR, Beck’s triad (decreased BP, increased JVP with prominent x but absent y, quiet heart sounds), pulsus paradox (pulse fading on inspiration), Kussmaul’s sign
What is Beck’s triad?
Decreased BP
Increased JVP with prominent x descent but absent y descent
Quiet heart sounds
What is pulsus paradox?
Pulse fading on inspiration
What is Kussmaul’s sign?
Paradoxical rise of JVP with inspiration
What are the investigation for tamponade?
CXR, ECG, echo
In tamponade what would you find on ECG?
Low voltage QRS complexes, electrical alternans
What would you find on CXR in tamponade?
An enlarged globular heart
What would you find on echo in tamponade?
An echo free space surrounding the heart
What is the management of tamponade?
Urgent pericardiocentesis!
Seek expert help
Treat cause
Send fluid for culture, ZN stain and cytology
