Pericardial effusion and Cardiac tamponade

Question 1

Cardiac tamponade starts with accumulation of fluid in the ______ ___

Answer 1

pericardial sac

Question 2

Accumulation of fluid in the pericardial sac results in increased pressure on the heart and impairs ______ _____

Answer 2

diastolic filling

Question 3

The Accumulation of fluid in the pericardial sac impairing diastolic filling causes decreased _____ ______

Answer 3

cardiac output

Question 4

What is Beck’s triad in cardiac tamponade?

Answer 4

Hypotension (or rapidly falling bp)
Raised JVP
Muffled S1 and S2 heart sounds

Question 5

What is pulsus paradoxus?

Answer 5

Fall in systolic blood pressure of 10+ mmHg on inspiration

Is a good indicator of cardiac tamponade
Also can be seen in severe asthma, COPD and obstructive sleep apnoea

Question 6

What is Kussmaul’s sign?

Answer 6

Paradoxical raised JVP with inspiration

Usually seen in constrictive pericarditis, restrictive cardiomyopathy and severe right heart failure

Question 7

How is cardiac tamponade diagnosed?

Answer 7

ECG may show electrical alternans: varying QRS amplitudes due to heart bouncing back and forth in increased pericardial fluid

CXR: big globular heart

ECHO = diagnostic

Question 8

How is pericardial effusion treated?

Answer 8

Underlying cause treated eg for pericarditis: NSAIDs and colchicine

Question 9

How is cardiac tamponade treated?

Answer 9

Urgent pericardiocentesis