Cardiac Tamponade

Overview

Cardiac tamponade occurs when increased pericardial pressure restricts cardiac filling and reduces effective cardiac output.

Rapidly accumulating fluid can cause tamponade even when the absolute volume is relatively small.

Clinical Features

Features may include hypotension, raised JVP, muffled heart sounds, tachycardia, dyspnea, and pulsus paradoxus.

Tamponade is a clinical hemodynamic diagnosis supported by echocardiography; do not wait for every classic sign to appear.

Investigation

Bedside echocardiography can demonstrate pericardial fluid and signs of impaired cardiac filling.

Management

Hemodynamically significant tamponade requires urgent drainage of the pericardial space while simultaneously addressing the cause.

Clinical Pearls