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Internal Medicine

Cardiac Tamponade

Last Updated on July 26, 2022

Introduction

• Cardiac tamponade = pericardial effusion that causes increased intrapericardial pressure, leading to reduced ventricular filling & reduced cardiac output

Causes

Trauma
• Viral infection
• Tuberculosis
• Malignancy
Radiation to the chest area

Presentation

Individual with underlying risk factors of cardiac tamponade, presented with acute onset of SOB + hypotension (shock)

Symptoms

Shortness of breath
• Orthopnoea

Signs

• Hypotension
• Raised JVP
• Muffled heart sound

Investigations

ECG

Electrical alternans
• Microvoltage

Imaging

(i) Chest X-ray

(ii) Bedside ultrasound of heart

Diagnosis

Beck’s triad

• Hypotension
• Raised JVP
• Muffled heart sound

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However, Beck’s triad is not sensitive for cardiac tamponade

Three-Step scoring System

Management

Pericardiocentesis (if indicated)

  1. Pericardiocentesis
  2. Shock
  3. Chest X-rays

Q&A

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