The Rational Clinical Examination
David L. Simel, Drummond Rennie
Cardiac Tamponade
Christopher L. Roy, Melissa A. Minor, M. Alan Brookhart, Niteesh K. Choudhry
On cardiac auscultation, the examiner may note diminished heart sounds, although this finding may...
Topics Discussed:
beck triad, cardiac tamponade, chest x-ray, diagnostic process, echocardiography, electrocardiogram, pulse, pulsus paradoxus, reference standards
Excerpt:
"Cardiac tamponade occurs when fluid trapped in the pericardial
space compresses the heart and compromises cardiac output. The consequences
of cardiac tamponade range from barely detectable effects to overt
hemodynamic collapse.1-3 When a pericardial effusion becomes large enough
or accumulates rapidly enough to cause hemodynamic consequences,
readily observed symptoms and signs herald impending circulatory
collapse that necessitates urgent therapeutic intervention.The pericardial sac consists of 2 layers: an outermost parietal
pericardium and the inner visceral pericardium (epicardium) that
reflects directly over the surface of the heart. Normally, no more than
15 to 30 mL of fluid exists between the 2 layers, held at pressures
approximating the pleural pressure or approximately 5 mm Hg lower
than central venous pressure.13,14..."
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