Cardiac tamponade | Nature Reviews Disease Primers

ABSTRACT Cardiac tamponade is a medical emergency caused by the progressive accumulation of pericardial fluid (effusion), blood, pus or air in the pericardium, compressing the heart chambers

and leading to haemodynamic compromise, circulatory shock, cardiac arrest and death. Pericardial diseases of any aetiology as well as complications of interventional and surgical procedures

or chest trauma can cause cardiac tamponade. Tamponade can be precipitated in patients with pericardial effusion by dehydration or exposure to certain medications, particularly vasodilators

or intravenous diuretics. Key clinical findings in patients with cardiac tamponade are hypotension, increased jugular venous pressure and distant heart sounds (Beck triad). Dyspnoea can

progress to orthopnoea (with no rales on lung auscultation) accompanied by weakness, fatigue, tachycardia and oliguria. In tamponade caused by acute pericarditis, the patient can experience

fever and typical chest pain increasing on inspiration and radiating to the trapezius ridge. Generally, cardiac tamponade is a clinical diagnosis that can be confirmed using various imaging

modalities, principally echocardiography. Cardiac tamponade is preferably resolved by echocardiography-guided pericardiocentesis. In patients who have recently undergone cardiac surgery and

in those with neoplastic infiltration, effusive–constrictive pericarditis, or loculated effusions, fluoroscopic guidance can increase the feasibility and safety of the procedure. Surgical

management is indicated in patients with aortic dissection, chest trauma, bleeding or purulent infection that cannot be controlled percutaneously. After pericardiocentesis or pericardiotomy,

NSAIDs and colchicine can be considered to prevent recurrence and effusive–constrictive pericarditis. Access through your institution Buy or subscribe This is a preview of subscription

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* Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS UNVEILING THE CAUSES OF PERICARDIAL EFFUSION IN A

CONTEMPORARY CASE SERIES OF PERICARDIOCENTESIS IN LATIN AMERICA Article Open access 26 September 2022 IMPACT OF PREOPERATIVE CLINICAL AND IMAGING FACTORS ON POST-PERICARDIECTOMY OUTCOMES IN

CHRONIC CONSTRICTIVE PERICARDITIS PATIENTS Article Open access 15 November 2024 INTERVENTIONAL THERAPIES FOR PULMONARY EMBOLISM Article 12 May 2023 REFERENCES * Chinchoy, E. _Handbook of

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pericardial effusion. _Eur. Heart J._ 34, 1186–1197 (2013). PubMed  Google Scholar  Download references ACKNOWLEDGEMENTS The authors dedicate this Primer to the giants in the field of

pericardial diseases: David H. Spodick, Ralph Shabetai and Bernhard Maisch. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Sackler Faculty of Medicine, Tel Aviv University, Bnei Brak, Israel

Yehuda Adler * College of Law and Business, Ramat Gan, Israel Yehuda Adler * Department of Cardiology, University Clinical Centre of Serbia, Belgrade, Serbia Arsen D. Ristić & Petar M.

Seferović * Faculty of Medicine, Belgrade University, Belgrade, Serbia Arsen D. Ristić, Ivana Burazor & Petar M. Seferović * Cardiothoracic Department, Cardiology, University Hospital

Santa Maria della Misericordia, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy Massimo Imazio * Department of Biomedical and Clinical Sciences, Fatebenefratelli

Hospital, The University of Milan, Milan, Italy Antonio Brucato * Department of Internal Medicine-Cardiology, Philipps University Marburg, Marburg, Germany Sabine Pankuweit * Institute for

Cardiovascular Diseases “Dedinje“ and Belgrade University, Faculty of Medicine, Belgrade, Serbia Ivana Burazor * Serbian Academy of Sciences and Arts, Belgrade, Serbia Petar M. Seferović *

Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA Jae K. Oh Authors * Yehuda Adler View author publications You can also search for this author inPubMed Google Scholar *

Arsen D. Ristić View author publications You can also search for this author inPubMed Google Scholar * Massimo Imazio View author publications You can also search for this author inPubMed 

Google Scholar * Antonio Brucato View author publications You can also search for this author inPubMed Google Scholar * Sabine Pankuweit View author publications You can also search for this

author inPubMed Google Scholar * Ivana Burazor View author publications You can also search for this author inPubMed Google Scholar * Petar M. Seferović View author publications You can

also search for this author inPubMed Google Scholar * Jae K. Oh View author publications You can also search for this author inPubMed Google Scholar CONTRIBUTIONS Introduction (Y.A., A.D.R.

and I.B.); Epidemiology (Y.A., A.B., S.P. and I.B.); Mechanisms/pathophysiology (Y.A., M.I., S.P. and P.M.S.); Diagnosis, screening and prevention (Y.A. and M.I.); Management (Y.A., A.D.R.,

M.I., A.B. and J.K.O.); Quality of life (Y.A., A.D.R. and P.M.S.); Outlook (A.B., Y.A. and I.B.). Y.A. and A.D.R. contributed equally to the Primer. CORRESPONDING AUTHOR Correspondence to

Yehuda Adler. ETHICS DECLARATIONS COMPETING INTERESTS The institution of A.B. received funding from Kiniksa Pharmaceuticals as an investigative site. A.B. also received an unrestricted

research grant from Swedish Orphan Biovitrum AB (SOBI) and ACARPIA as well as travel and accommodation to attend an advisory committee organized by SOBI and an advisory board organized by

Kiniksa Pharmaceuticals. The other authors declare no competing interests. PEER REVIEW PEER REVIEW INFORMATION _Nature Reviews Disease Primers_ thanks A. Abbate, M. Chetrit, C. L. Jellis, M.

M. Lewinter and J.-L. Vincent for their contribution to the peer review of this work. ADDITIONAL INFORMATION PUBLISHER’S NOTE Springer Nature remains neutral with regard to jurisdictional

claims in published maps and institutional affiliations. SUPPLEMENTARY INFORMATION 41572_2023_446_MOESM1_ESM.MP4 Supplementary Video 1. Echocardiography in the diagnosis of cardiac

tamponade. Two-dimensional echocardiographic apical long-axis view showing a large pericardial effusion with characteristic right atrial and right ventricular collapse in real time.

41572_2023_446_MOESM2_ESM.MP4 Supplementary Video 2. Echocardiography in the diagnosis of cardiac tamponade. Two-dimensional echocardiographic subxiphoid view showing the swinging heart in

the large effusion. 41572_2023_446_MOESM3_ESM.MP4 Supplementary Video 3. Echocardiography in the diagnosis of cardiac tamponade. Two-dimensional echocardiographic parasternal long-axis view

showing a large pericardial effusion with characteristic ventricular septal motion in real time. 41572_2023_446_MOESM4_ESM.MP4 Supplementary Video 4. Echocardiography in the diagnosis of

cardiac tamponade. M-mode echocardiography of a large pericardial effusion with characteristic ventricular septal motion in real time. RIGHTS AND PERMISSIONS Springer Nature or its licensor

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Ristić, A.D., Imazio, M. _et al._ Cardiac tamponade. _Nat Rev Dis Primers_ 9, 36 (2023). https://doi.org/10.1038/s41572-023-00446-1 Download citation * Accepted: 05 June 2023 * Published: 20

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