Cardiac Tamponade

Question 1

Define Cardiac Tamponade:

Answer 1

Accumulation of pericardial fluid under pressure, which raises the intra-pericardial pressure, hence there is poor ventricular filling, thus cardiac output decreased.

Question 2

Cardiac Tamponade: Causes: 
T
AP
CP
PE
AD
HD
W
PCB

Answer 2

Cardiac Tamponade: Causes: 
Trauma - car accident
Acute Pericarditis
Constrictive Pericarditis
Pericardial Effusion
Aortic Dissection
Haemodialysis 
Warfarin
Post-Cardiac Biopsy

Question 3

Cardiac Tamponade: Signs:
P
JVP
HS
PP
KS

Answer 3

Cardiac Tamponade: Signs:
Pulse: raised
JVP: raised
Heart Sounds: Muffled S1 & S2
Pulsus Paradoxus: large decrease in stroke volume
Kussmaul’s Sign: JVP rises on inspiration

Question 4

Cardiac Tamponade: Investigations
Beck's Triad: 1. 2. 3. 
E
E
C

Answer 4

Cardiac Tamponade: Investigations
Beck's Triad: 
1. Falling BP 
2. Rising JVP 
3. Muffled HS (S1 & S2)
ECG: low voltage QRS, electrical alternans
Echocardiogram - diagnostic 
Chest X Ray - cardiomegally - globular if > 250 ml fluid.

Question 5

Cardiac Tamponade: Treatment:
D
C

Answer 5

Cardiac Tamponade: Treatment:
Drain urgently: Pericardiocentesis, Pericardial Window
Culture drained fluid: TB Culture/ZN Stain

Question 6

Cardiac Tamponade: Acute Triad: DDD
1.
2.
3.

Answer 6

Cardiac Tamponade: Acute Triad: DDD

1. Distant heart sounds
2. Decreased BP
3. Distended (swollen) veins

Question 7

When should you suspect Cardiac Tamponade?
1. 
2.
3.
Despite...

Answer 7

When should you suspect Cardiac Tamponade?
1. Elevated JVP
2. Persistent Hypotension (Low BP)
3. Tachycardia
Despite.. fluid resuscitation in a patient with chest wall trauma.