Dr.

Muh A Sungkar, SpPD, SpJP

Clinical Features

significant compression of the heart by

accumulating pericardial contents
( liquids, pus, blood, clots, and gas singly
or combined )

surgical tamponade
Intrapericardial hemorrhage

medical tamponade
low-intensity inflammatory process

SYMPTOMS

Chest discomfort
Tachypnea
Dyspnea on exertion
Orthopnea
Cough and dysphagia
Weak and anorectic
Feeling faint to having syncope
Anemia
Weakness
Complication :
renal failure;
abdominal plethora
mesenteric ischemia.
or hepatic (shock liver)

PHYSICAL FINDINGS

Tachycardia
Heart sounds may be distant
Relative accentuation of the pulmonic component of S2
Precordium may be quiet and an apex beat not palpable
Significant tamponade produces absolute or
Relative hypotension
Cool extremities, nose, and ears, sometimes with
acral cyanosis
Central cyanosis : right-to-left shunt
Fever
Jugular venous distention
Peripheral venous distention: forehead, scalp, and
ocular fundi
Kussmaul sign
Pulsus Paradoxus

DIAGNOSIS

Hypotension and the following findings

Elevated systemic venous pressure
Falling blood pressure
Pulsus paradoxus
Tachycardia
Dyspnea or tachypnea whit clear lungs chest and
abdominal wounds
Anticoagulant or thrombolytic therapy
Drugs such as cyclosporine
Recent cardiac surgery
Blunt chest trauma
Malignancies
Connective tissue disease
Renal failure
Septicemia

Cardiac tamponade

Physiology of pulsus paradoxus

Cardiac tamponade and compensatory mechanisms

Pericardial tamponade: hemodynamics

Pericardial effusion with tamponade: ECG findings

Pericardial effusion with tamponade: chest radiograph

Large pericardial effusion with tamponade.

Biatrial (RA and LA) collapse (arrows).

Large pericardial effusion (PE) with tamponade.

Arrow indicates right ventricular (RV) collapse

Pericardial effusion with tamponade: echocardiogram

Treatment
MEDICAL TREATMENT
PERICARDIAL DRAINAGE
SURGICAL DRAINAGE