ACUTE CARDIAC TAMPONADE

Cardiac tamponade (pericardial tamponade, cardiac compression) is a clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise. 

 CAUSES:
  • chest trauma
  • myocardial rupture
  • cancer
  • uremia
  • pericarditis
  • cardiac surgery
COMPLAINTS:
  •  Shortness of breath
  •  Weakness
  •  Lightheadedness
  •  Cough.
  •  Retrograde aortic dissection


CLINICAL SIGNS:

  • Rapid breathing
  • Weak or absent peripheral pulses
  • BECK's TRIAD(was described by the thoracic surgeon Calude S. Beck in 1935.):
beck


  • pulsus paradoxus ( a fall of systolic blood pressure of >10 mmHg during the inspiratory phase. )
  • fast heart rate
  • ECG:  low voltage QRS complexes
cardiac tamponade ECG

  • Echocardiography: enlarged pericardium or collapsed ventricles
cardiac tamponade ECho

  • X-RAY: enlarged globular-shaped heart.

cardiac tamponade X-RAY
  • Chest CT and MRT signs.

 TREATMENT:
  • Pericardiocentesis and/or pericardiotomy
  • Oxygen and/or mechanical ventilation
  • Venous catheterization 
  • Volume expansion with cristalloids, colloids, blood or plasma if nesessary
  • Leg elevation to maximize preload
  • Inotrope drugs




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