Cardiac Tamponade

Cardiac Tamponade

Pathology:                   Occurs when the pericardial space fills up withfluid faster than it can stretch, resulting in increased pressure within thepericardial sac

As fluid accumulates less bloodenters the ventricles during diastole as the increasing pressure presses on theheart and forces the septum to bend into the left ventricle, this leads todecreased stroke volume and eventually cardiac arrest if left untreated


Aetiology:                    Causesare similar to that of pericardial effusion


Symptoms:                  Centralchest pain, shortness of breath, fatigue, cough, syncope


Signs:                              Sinustachycardia, Kussmaul’s sign, pericardial rub, pulsus paradoxus,

Beck’sTriad - hypotension, raised JVP, muffled heart sounds


Investigations:          ECG:Low QRS voltage, electrical alternans (beat-to-beat shift in QRS/P waves)

Chest X-Ray: Large globularheart, cardiomegaly seen with >200 ml of blood

Echo: Systolic collapse of right atriumfollowed by diastolic collapse of right

Ventricle. Fluid accumulates around the heart whichstarts posteriorly.


Treatment:                  Pericardiocentesis

Opensurgical drainage with pericardiectomy or pericardial window


Complications:          Cardiac arrest fromreduced cardiac output


Prognosis:                   Reduced mortalityand morbidity in early diagnosis and treatment




















Figure 1.17 Beck’s Triad

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