Cardiac Tamponade and Pericardial Disease
First Things First (assess for & treat the following):
- Is pt hemodynamically stable?
- Vital signs, including bilateral pulses, BP & pulsus paradoxus
- Pulse oximetry or ABG
- Consider invasive monitoring (PA catheter, arterial line) to help establish the diagnosis as well as direct therapy.
- Ensure adequate volume resuscitation.
- Does pt have pulmonary edema?
- If yes, then a pericardial etiology is unlikely.
- Does pt have a predisposing condition for tamponade or other pericardial disease?
- Recent cardiac surgery or trauma, neoplastic disease, recent viral infection or TB, uremia, history of mantle irradiation
- Consider aortic dissection causing tamponade.
- Consider acute MI & PE in any pt w/ chest pain.
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