E: Cardiac Tamponade Flashcards
Defined pericardial effusion
Accumulation of fluid within the pericardial space
What can cause pericardial effusion
- Pericarditis
- Stab wound of the pericardium in surgery, trauma, post MI
- aortic dissection
How will pericardial effusion present clinically
- Dyspneoa
- Chest pain
- Bronchial breathing
- Nausea
- Hiccups
Why may an individual have hiccups in pericardial effusion
Due to compression of the phrenic nerve
What is Ewart’s sign
Bronchial breathing in pericardial effusion caused by compression of the lower lobe
How will heart sounds present in pericardial effusion
Muffled heart sounds
What 4 investigations may be ordered in pericardial effusion
- ECG
- CXR
- ECHO
- Pericardiocentesis
What will a chest x-ray show in pericardial effusion
If fluid volume is more than 300ml it will show an enlarged globular heart
What will a ECG in pericardial effusion
Electrical alternans
What will an ECHO show in pericardial effusion
Free fluid space surrounding the heart
When is pericardiocentesis performed
If bacterial cause is suspected (pericarditis)
What is the treatment of pericardial effusion
Pericardiocentesis can be therapeutic. Underlying cause should be addressed
What is the major complication of pericardial effusion
Cardiac tamponade. Where accumulation in pericardium causes compression of the heart
What is cardiac tamponade
accumulation of fluid within the pericardium that compresses the heart
What are the two types of fluid that can accumulate in the pericardium
- Haemopericardium (blood)
- Serous fluid
What are 4 causes of haemopericardium
- Cardiac surgery
- MI causing rupture of wall
- Aortic dissection
- Trauma
What are 5 causes of serous pericardial effusion
- Pericarditis
- Uremic syndrome
- Hypothyroidism
- Autoimmune conditions
- Malignancy
What are the symptoms of cardiac tamponade
- Reterosternal chest pain
- Orthopneoa
- Dyspnoea
What is Beck’s triad
It is a triad of symptoms/signs seen in cardiac tamponade and includes
- Hypotension
- Muffled heart sounds
- Raised JVP
What sign will be present in cardiac tamponade
Kussmaul’s sign
What is kussmaul’s sign
JVP rises on inspiration
what pulse is present in cardiac tamponade
Pulsus paradoxus
what is pulses paradoxes
pulse decreases on inspiration
explain JVP in cardiac tamponade and why this occurs
there is an absent Y descent, as there is limited right ventricle filling due to reduced area.
