- a collection of fluid in the pericardial space which puts pressure on the ventricles of the heart and limits it ability to fill and pump effectively.
- The end result is ineffective pumping of blood, shock, and often death.
- Cardiac tamponade occurs when the pericardial space fills up with fluid faster than the pericardial sac can stretch.
- Tamponade leads to obstructive shock which reduces pre-load (and reduces CO) and eventual cardiac arrest with pulseless electrical activity.
- One of the most common settings for cardiac tamponade is in the first 24 to 48 hours after heart surgery
- Classical cardiac tamponade presents three signs, known as Beck’s triad. Hypotension, jugular-venous distension, and muffled heart sounds.
- Other signs of tamponade include pulsus paradoxus (a drop of at least 10mmHg in arterial blood pressure on inspiration), and ST segment changes on the electrocardiogram, which may also show low voltage QRS complexes (due to reduced ventricular activity).
- Diagnosis best made by echo (=enlarged pericardium or collapsed ventricles)
- CXR = ‘large globular / hot water bottle’ heart