Cardiac tamponade Flashcards
1
Q
what are risk factors for developing cardiac tamponade?
A
trauma pericarditis large idiopathic pericardial effusion malignancy aortic dissection
less common; recent cardiac procedure uraemia hypothyroidism autoimmune condition
2
Q
what are the features of tamponade?
A
muffled heart sound hypotension elevated JVP tachycardia tachypnoea absent Y descent on JVP prominent X descent on JVP pluses paradoxus kaussmaul sign ECG - electrical alternans
3
Q
what feature on ECG is found in tamponade?
A
electrical alternans
- alteration of QRS complex amplitude between beats
4
Q
what is pulses paradoxus?
A
large drop in BP during inspiration (> 10mmHg)
5
Q
what is the main differential diagnosis of tamponade?
A
constrictive pericarditis
6
Q
what are the main differenced between tamponade and constrictive pericarditis?
A
tamponade
- absent Y descent on JVP
- pulses paradoxus present
- kausmaul sign = rare
constrictive pericarditis
- X and Y descent on JVP
- no pulses paradoxus
- kausmaul sign present
- pericardial calcifications on CXR
7
Q
what are complications associated with cardiac tamponade?
A
cardiac arrest
recurrent or refractory pericarditis or pericardial effusions
organ hypoperfusion
effusive-constrictive pericarditis
8
Q
what is Kaussmaul sign?
A
a paradoxical rise in JVP during inspiration
