Pericardial tamponade

Question 1

Aetiology of pericardial tamponade

Answer 1

CUP CRAM

• Chest trauma/cardiac surgery (CABG)
• Uraemia
• Pericarditis
• Cancer
• Retrograde aortic dissection
• Anticoagulant therapy
• Myocardial rupture

Question 2

Symptoms of pericardial tamponade (2)

Answer 2

1. SOB

2. Weakness/feeling faint

Question 3

Signs of pericardial tamponade (5)

Answer 3

Beck’s triad

1. Blood pressure low
2. Elevated JVP
3. Cardiac sounds muffled

Other

4. Pulsus paradoxus
5. Tachycardia

Question 4

Investigations for pericardial tamponade (3) and the findings on each

Answer 4

1. Echocardiogram - enlarged pericardium, bulging of right ventricle into left, ventricular collapse
2. ECG - ST changes, low voltage QRS, electrical alternans (heart wobble in sac)
3. CXR - enlarged globular-shaped heart

Question 5

Management of pericardial tamponade

Answer 5

1. Oxygen, general shock management

3. Pericardiocentesis

Question 6

Complications/prognosis of pericardial tamponade

Answer 6

1. PEA (pulseless electrical activity)

2. High morbidity and mortality