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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Last updated: April 12, 2010