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Cardiac Tamponade
Radiation tx
Uremia
Trauma
Clinical Presentation
Sxs
Physical Exam
Pulsus Paradoxus
In pts w/ pre-existing
elevs in diastolic
pressures and/or volume
(eg, LV dysfnx, AI and
ASD)
Diagnosis
EKG
CXR
TTE
R Heart Cath
CT, MRI
EKG Findings
Common Findings
Sinus tachycardia
Non-specific ST segment and T wave changes
Changes assocd w/ acute pericarditis (incl diffuse STE & PR
depression)
Other Findings
EKG Findings
CXR Findings
Separation of mediastinal /
retrosternal fat and
epicardial fat by > 2 mm
TTE
Pericardial effusion
Transmitral resp varn > 25% transtricuspid varn > 50% are char of tamponade.
R Heart Cath
Near equalization
(w/in 5 mm Hg) of
the RA, RV, PCWP,
RV diastolic, & LV
diastolic pressures
RA pressure
tracings show
diminshed systolic
y descent
Tx of Cardiac Tamponade
Tx of Cardiac Tamponade
16- or 18-gauge
needle inserted at
angle of 30-45 to
the skin, near the
left xiphocostal
angle, aiming toward
the L shoulder
Tx of Recurrent Effusions
Pericardectomy
Pericardial-peritoneal shunt
References
LearningRadiology.com