Cardiac Tamponade - Clinical manifestation

Symptoms vary with the underlying cause and the acuteness of the tamponade. Patients with acute tamponade may present with dyspnea, tachycardia, and tachypnea. Cold and clammy extremities from hypoperfusion are also observed in some patients.

• Patients with systemic or malignant disease present with weight loss, fatigue, or anorexia.

• Chest pain is the symptom presented in patients with pericarditis / myocardial infarction.

• Musculoskeletal pain or fever may be present in patients with an underlying connective tissue disorder.

• A history of renal failure can lead to a consideration of uremia as a cause of pericardial effusion.

• Careful review of a patient's medications may indicate drug-related lupus leading to a pericardial effusion.

• Recent cardiovascular surgery, coronary intervention, or trauma can lead to the rapid accumulation of pericardial fluid and tamponade.

• Consider HIV-related pericardial effusion and tamponade if the patient has a history of intravenous drug abuse or opportunistic infections.

• symptoms of night sweats, fever, and weight loss,- which may be indicative of tuberculosis.

Signs of the cardiac tamponade are,

• Distended neck veins.

• The Beck triad or acute compression triad

• Physical findings refer to increased jugular venous pressure, hypotension, and diminished heart sounds.

• These findings result from a rapid accumulation of pericardial fluid. However, this classic triad is usually observed in patients with acute cardiac tamponade.

• Pulsus paradoxus or paradoxical pulse: This is an exaggeration (>12 mm Hg or 9%) of the normal inspiratory decrease in systemic blood pressure.

• Kussmaul sign

• Ewart sign

• The 'y' descent

Category: Medicine Notes