Cardiac Tamponade (Advanced Evaluation)

Cardiac tamponade is a medical emergency in which fluid in the pericardial space raises intrapericardial pressure, impairs filling of the cardiac chambers and drops cardiac output to critical levels. The rate of fluid accumulation and pericardial compliance, rather than absolute volume, determine the clinical picture.

Common causes include malignancy, uremia, trauma, prior cardiac surgery, aortic dissection, infective pericarditis and anticoagulation. The classic Beck triad (hypotension, jugular venous distension and muffled heart sounds) is a late finding.

Diagnosis is made by echocardiography demonstrating effusion with diastolic right atrial/ventricular collapse and respiratory variation of mitral/tricuspid inflow. Urgent pericardiocentesis (percutaneous or surgical) is lifesaving; the underlying cause should be investigated simultaneously.