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.):

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

• Echocardiography: enlarged pericardium or collapsed ventricles

• X-RAY: enlarged globular-shaped heart.

• 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