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.