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Cardiac tamponade

最后审阅: 24 Sep 2025
最后更新: 02 Apr 2025

小结

定义

病史和体格检查

关键诊断因素

  • malignancy
  • presence of other risk factors
  • dyspnea
  • elevated jugular venous pressure (JVP)
  • distant heart sounds
  • pulsus paradoxus
  • hypotension
  • tachycardia
  • recent cardiac surgery or intervention
  • Beck triad: hypotension, distant heart sounds, and elevated JVP
完整详情

其他诊断因素

  • chest pain
  • abdominal pain
  • fever
  • pericardial rub
完整详情

危险因素

  • malignancy
  • aortic dissection
  • purulent pericarditis
  • large idiopathic chronic pericardial effusion
  • post-cardiac surgery or intervention
  • tuberculosis (TB)
  • autoimmune disease
  • hypothyroidism
  • end-stage renal failure
  • anticoagulation
完整详情

诊断性检查

首要检查

  • ECG
  • transthoracic echocardiogram
  • CXR
  • CBC
  • erythrocyte sedimentation rate/CRP
  • cardiac enzymes
完整详情

需考虑的检查

  • cardiac CT
  • cardiac MRI
  • cardiac catheterization
  • pericardiocentesis fluid for culture and cytology
完整详情

治疗流程

急症处理

without hemopericardium, trauma, or purulent effusion

with hemopericardium, trauma, or purulent effusion

撰稿人

作者

Antonio Abbate, MD, PhD

Ruth C. Heede Professor of Cardiovascular Medicine

Division of Cardiovascular Medicine

Berne Cardiovascular Research Center

University of Virginia School of Medicine

Charlottesville

VA

利益声明

AA has received consultant fees from Kiniksa Pharmaceuticals. He is an author of references cited in this topic.

鸣谢

Dr Antonio Abbate would like to gratefully acknowledge Dr Vaikom S. Mahadevan, Dr Harsh Agrawal, Dr Jonathan Bella, Dr Liran Blum, and Dr Michael Spinelli, previous contributors to this topic.

利益声明

VSM declares that he is a proctor for Edwards Lifesciences for transcatheter valves and also a proctor for Abbott for closure devices. HA, JB, LB, and MS declare that they have no competing interests.

同行评议者

Ramon Castello, MD

Professor of Medicine

Director of Echocardiography

Mayo Clinic

Jacksonville

FL

利益声明

RC declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013 Sep;26(9):965-1012.全文  摘要

Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015 Nov 7;36(42):2921-64.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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