Tag Archives: Cardiac tamponade

9/19 Monday case presentation with Alice: Cardiac tamponade

A man in his 60s with hx of OSA, HLD, HTN presents with 1 day hx of dyspnea, coughing and low grade fever found to have large pericardial effusion of likely viral etiology, positive tamponade physiology, s/p pericardiocentesis of 920cc serosanguineous effusion. 
Key Learning Points
-While the size of the pericardial effusion is important, it is the rate of fluid accumulation that has the greatest effect on hemodynamics
-Ddx for pericardial effusion
       Infectious:  Viral/Bacterial/Fungal/Parasitic
       Autoimmune/Autoinflammatory
       Neoplastic – primary OR metastatic disease
       Cardiac – pericarditis/myocarditis/Dressler’s/dissecting aortic aneurysm
       Traumatic
       Metabolic – hypothyroidism, uremia
       Radiation
-Important procedural complications of pericardiocentesis: myocardial puncture or laceration; vascular injury, pneumothorax, air embolism, arrhythmia, intraabdominal organ damage, acute hemopericardium
Sweet video link from the Stanford 25 demonstrating how to measure pulsus paradoxus: