Cardiac tamponade

Medical emergency; can be rapidly fatal if not promptly drained through needle pericardiocentesis or surgical drainage of the pericardium.

Clinical signs include tachycardia, hypotension, distant heart sounds, elevated jugular venous pressure, and a pulsus paradoxus >10 mmHg.

Echocardiography is essential for evaluation.

May be caused by any disorder that results in pericardial effusion.

Pericardiocentesis may be complicated by puncture or laceration of the coronary, internal mammary, or pericardial blood vessels.

Cardiac tamponade is the accumulation of pericardial fluid, blood, pus, or air within the pericardial space that creates an increase in intra-pericardial pressure, restricting cardiac filling and decreasing cardiac output. Cardiac tamponade is a cardiac emergency and can be fatal if it is not quickly diagnosed and treated promptly.[1]LeWinter MM, Kabbani S. Pericardial diseases. In: Zipes DP, Libby P, Bonow P, et al. Braunwald's heart disease: a textbook of cardiovascular medicine. 7th ed. Philadelphia: WB Saunders; 2005:1757-1781. The diagnosis is based on clinical suspicion and supported by evidence of haemodynamic compromise on echocardiography.