Cardiac Tamponade
Definition
Also known as pericardial tamponade
Compression of the heart by collection of fluid in the pericardial cavity
Etiology
Hypothyroidism - slow collection of fluid - slow compression
Uremia
Trauma, myocardial rupture - rapid collection - quick tamponade
Pericarditis
Anticoagulant therapy
Tuberculous effusion
Fluid may be blood, effusion or pus
Pathophysiology
Outer layer of the pericardium is fibrous
Collection of fluid causes an increase of pressure inside the pericardial cavity
Heart is compressed
Diastole is restricted
Filling of the chambers reduced
Stroke volume decreases
Obstructiv shock results
ECG : Pulseless Electrical Activity
Signs and Symptoms
Pulsus paradoxus (a drop of at least 10 mm Hg in arterial blood pressure with inspiration)
Low voltage RS complexes
Hypotension or shock
Tachycardia + / -
Dyspnea/tachypnea/air hunger at rest
Decreasing level of consciousness
Convulsions
Treatment
O2
Pericardiocentesis - subxiphoid approach or through 5th Intercostal space or a left parasternal approach 3 -5 cm laterally.
Monitoring
Emergency thoracotomy
