Pericardial Effusion/tamponade
Basics
Description
Description
- Pericardial effusion:
- Pericardial sac usually contains 15–40 cc of fluid
- Collection of additional fluid = effusion
- Pericardial tamponade:
- Accumulation of pericardial fluid causes an elevation of pressure in the pericardial space, resulting in impairment of ventricular filling and decreased cardiac output
- Depends on size and speed of fluid accumulation
- Increase of as little as 80–120 cc of fluid may lead to a rise in pericardial pressure
- Up to 70% present in “early tamponade” and appear clinically stable
- Occurs in 2% of patients with penetrating chest trauma
Etiology
Etiology
- Medical causes:
- Pericarditis (20%):
- 90% idiopathic or viral
- Bacterial, fungal, parasitic, tuberculosis, HIV
- Malignancy (13%):
- Lymphoma, leukemia, melanoma, breast, lung
- Metastatic disease, primary malignancy, postradiation
- Postmyocardial infarction (8%):
- Acute: 1–3 d after acute myocardial infarction (AMI)
- Subacute (Dressler syndrome): Weeks to months after AMI
- Incidence reduced with reperfusion therapy
- End-stage renal disease, uremia (6%)
- Autoimmune/collagen vascular disease (5%): Rheumatoid arthritis, systemic lupus erythematosus, scleroderma
- Rheumatic fever
- Radiation therapy
- Myxedema
- Congestive heart failure (CHF), valvular heart disease
- Drug toxicity (isoniazid, doxorubicin, procainamide, hydralazine, phenytoin)
- Idiopathic
- Pericarditis (20%):
- Surgical causes:
- Penetrating chest trauma
- Thoracic aortic dissection
- Iatrogenic (cardiac catheterization, postcardiac surgery, central line placement)
- Blunt trauma rarely causes pericardial effusion
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Citation
Schaider, Jeffrey J., et al., editors. "Pericardial Effusion/tamponade." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307309/all/Pericardial_Effusion_tamponade.
Pericardial Effusion/tamponade. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307309/all/Pericardial_Effusion_tamponade. Accessed December 1, 2024.
Pericardial Effusion/tamponade. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307309/all/Pericardial_Effusion_tamponade
Pericardial Effusion/tamponade [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 December 01]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307309/all/Pericardial_Effusion_tamponade.
* Article titles in AMA citation format should be in sentence-case
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T1 - Pericardial Effusion/tamponade
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BT - 5-Minute Emergency Consult
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DB - Emergency Central
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