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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

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Monday, April 4, 2022

Pericardial Effusion

emDOCs
emDOCs - April 4, 2022 - By Taylor Franz, Janet S. Young
Reviewed by: Stephen Alerhand; Alex Koyfman; Brit Long
Pearls:
  • Predictive morbidity of developing tamponade may be dependent upon causative etiology. Malignant and tuberculous/bacterial effusions are more likely to develop cardiac tamponade when compared to viral or iatrogenic causes.
  • Tachycardia is the most common presenting sign for pericardial effusion. EKG findings are tachycardia, low voltage, and electrical alternans. Bedside ultrasound is diagnostic.
  • Hemodynamically stable cardiac tamponade can be managed with pericardiocentesis or pericardial window.
  • Hemodynamically unstable patients need emergent ultrasound-guided pericardiocentesis. Prep a large area of the chest in case you need to change your approach. Keep your needle in-plane at all times to avoid damage to surrounding structures.