Cardiac Tamponade - Cardiovascular

Snapshot
- A 45-year-old woman presents to the emergency room for chest discomfort and shortness of breath for the past few hours. She has a past medical history of systemic lupus erythematosus. Physical exam reveals hypotension, muffled heart sounds, distended jugular veins, and positive pulsus paradoxus. An ECG reveals low voltages and electrical alternans. Imaging shows an enlarged cardiac silhouette on radiography.

Summary
- Cardiac Tamponade is a rare condition caused by the accumulation of fluid or blood in the pericardial sac that leads to compression of the heart. The condition typically presents in adults and presents with Beck's triad and pulsus paradoxus.
- Diagnosis is made clinically with primary symptoms such as chest pain, shortness of breath, and low blood pressure and exam findings including muffled heart sounds and jugular venous distention.
- Treatment is usually immediate supportive measures including IV fluids, oxygen therapy, and blood pressure stabilizing agents. However, definitive treatment is pericardiocentesis. Operative treatment of pericardiotomy is indicated in refractory pericardial effusion, constrictive pericarditis, and purulent pericarditis.

Anatomy
- Pericardium is the membrane that encloses the heart
  
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Diagnosis
- Is based on combination of clinical presentation, ECG, echocardiogram, and chest radiography

Prognosis
- In acute cases, cardiac tamponade can develop rapidly
- In chronic cases, cardiac tamponade will develop gradually, as the pericardium can adjust slowly to the increased pressure over time

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