RT Book, Section
A1 Burstow, Darryl J.
A1 Luis, Sushil Allen
A1 Kane, Garvan C.
A1 Oh,  Jae K.
A2 Fuster, Valentin
A2 Narula, Jagat
A2 Vaishnava, Prashant
A2 Leon, Martin B.
A2 Callans, David J.
A2 Rumsfeld, John S.
A2 Poppas, Athena
SR Print(0)
ID 1202455886
T1 Percardial Effusion and Tamponade
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accesscardiology.mhmedical.com/content.aspx?aid=1202455886
RD 2024/09/15
AB Chapter  SummaryThis  chapter  outlines  the  etiology,  clinical  presentation,  investigation,  and  management  of  pericardial  effusions  and  cardiac  tamponade  (see  Fuster  and  Hurst’s  Central  Illustration).  Pericardial  effusions  are  most  commonly  idiopathic  in  etiology  in  developed  countries,  while  tuberculous  pericarditis  is  the  predominant  etiology  in  developing  countries.  Cardiac  tamponade  results  when  intrapericardial  pressure  elevation  impairs  cardiac  filling  with  resulting  hemodynamic  derangements.  The  rate  of  pericardial  fluid  accumulation  is  a  key  factor  in  the  development  of  cardiac  tamponade,  whereby  small  volume  rapidly  accumulating  pericardial  effusions  can  result  in  cardiac  tamponade.  Clinical  evaluation  of  patients  with  pericardial  effusions  should  assess  for  features  of  cardiac  tamponade,  including  symptoms,  tachycardia,  hypotension,  pulsus  paradoxus,  and  jugular  venous  pressure  elevation.  Transthoracic  echocardiography  is  the  key  diagnostic  test  in  the  evaluation  of  pericardial  effusions  and  assessment  of  cardiac  tamponade,  and  should  be  performed  in  patients  with  suspected  cardiac  tamponade.  Management  of  pericardial  effusions  should  target  the  underlying  etiology,  with  utilization  of  anti-inflammatory  therapy  in  those  with  evidence  of  active  pericardial  inflammation.  Amongst  patients  with  cardiac  tamponade,  pericardiocentesis  is  the  intervention  of  choice  and  should  ideally  be  performed  under  imaging  guidance.