Pericardial Tamponade

Pericardial tamponade is an abnormal accumulation of fluid in the pericardial space which results in diminshed filling of the atria and subsequently the ventricles complicated by reduction in cardiac output.

Th rapidity with which fluid accumulateds is a major factor in the development of tamponade.  Since blood usually accumulates rapidly hemorrhage into the pericardium is a  common cause of tampnade.  Penetrating trauma and hemorrhagig malignant effusions are therefore the common causes of tamponade.

 

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CLINICAL

Pulsus paradoxus

defined as an inspiratory systolic fall in arterial pressure of 10 mm Hg or more during normal breathing

Echo

right atrium and ventricle  – chamber collapse

25 percent have left atrial collapse

 

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43695 51M s/p ablation therapy for atrial fibrillation presents 3 weeks later with SOB pericardium fx small complex pericardial effusion fx thickened complex dx constrictive pericarditis caused by hemopericardium imaging radiology CTscan Courtesy Ashley Davidoff MD