cardiac tamponade/Pericardial effusions

Question 1

Pericardial effusion

Answer 1

-accumulated fluid
within the sac exceeds
the small amount that is
normally present
-Gradual accumulations of up to
1 to 2 L are often well tolerated
whereas the rapid addition of
even 80 to 200 mL will result in
markedly increased
intrapericardial pressures

Question 2

Pericardial effusion Occasionally occurs with:

Answer 2

1. Acute pericarditis
2. Fluid-retentive states
   (heart failure, renal
   failure, or cirrhosis)

Question 3

beck triad

Answer 3

1- JVD =JVP increased
2- hypotension (low BP )
3-muffled heart sound
(this triad special for cardiac tamponade)

Question 4

Symptoms

Answer 4

Fatigue, lightheadedness, and dyspnea
o patients may feel more comfortable
sitting forward

Question 5

Tamponade signs

Answer 5

Pulsus paradoxus
: Greater than 10
mm Hg decrease in systolic blood
pressure with inspiration

Question 6

Classic ECG findings

Answer 6

➢Sinus Tachycardia
➢Reduced QRS voltage
➢Nonspecific T-wave flattening
➢Electrical alternans
(change in QRS voltage from beat
to beat)

Question 7

Chest radiography:

Answer 7

Small to moderate effusions (less
than 200 to 300 mL) may not result
in significant findings on the chest
radiograph,
➢Larger pericardial effusions
typically present with an enlarged
cardiac silhouette with clear lung
fields
➢Cardiac silhouette enlargement
(not specific and cannot be
considered diagnostic for the
presence of a pericardial effusion)

Question 8

TREATMENT

Answer 8

Asymptomatic effusions, even large ones, may be
followed indefinitely with
clinical assessments
*Pericardiocentesis

Question 9

Pericardiocentesis indications

Answer 9

➢needed if fluid sampling is required to establish a
diagnosis, especially if symptoms are suggestive of
bacterial infection (i.e., purulent pericarditis)
➢Symptomatic patient