Pericardial tamponade: A comprehensive emergency medicine and echocardiography review

Alerhand, Stephen; Adrian, Robert James; Long, Brit; Avila, Jacob

doi:10.1016/j.ajem.2022.05.001

Cited by 51 publications

(22 citation statements)

References 200 publications

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“…Diagnostic tests that detect pericardial effusion includechest radiography (bottle-shapedheart), electrocardiogram, point-of-care ultrasonography,orCT. Every patient with signs, symptoms, or additional workup suggestive of pericardial effusion should undergo the bedside echocardiogramto evaluate for ultrasound signs of tamponade: diastolic right ventricular collapse, and systolic right atrial collapse, plethotic, non-collapsible inferior vena cava, and dondgraphic pulsus paradosux [16].…”

Section: Pericardial Tamponadementioning

confidence: 99%

Review of Hematology-Oncology Emergencies for Internal Medicine Residents

Baralo¹,

Ramesh²,

Deshpande³

et al. 2023

Cureus

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The prevalence of cancer continues to grow globally every year. With therapeutic advances over the recent decades, the prevalence of individuals living with cancer continues to increase. Internal medicine residents can see patients admitted to the hospital for cancer-related emergencies. Early identification and appropriate management of these emergencies have been shown to improve mortality and morbidity. In this article, we aim to review the recent updates in the management of commonly encountered oncologic emergencies in the practice of internal medicine residents. This review will cover spinal cord compression, superior vena cava syndrome, tumor lysis syndrome, hypercalcemia, pericardial tamponade, hypoglycemia, hyponatremia, bowel obstruction, increased intracranial pressure, leukostasis, hyperviscosity syndrome, neutropenic fever, and hypersensitivity reactions.

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Section: Pericardial Tamponadementioning

confidence: 99%

Review of Hematology-Oncology Emergencies for Internal Medicine Residents

Baralo¹,

Ramesh²,

Deshpande³

et al. 2023

Cureus

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“…Collapse during diastole, when the atrioventricular valves are open, suggests CaT. To assess this characteristic, it is recommended to use all available imaging windows, particularly the four-chamber apical window and the short-axis subxiphoid window 16…”

Section: Diagnosismentioning

confidence: 99%

“…In this assessment, the anteroposterior diameter of the inferior vena cava (IVC) is measured between 0.5 and 3 cm from the point of confluence with the hepatic vein, according to the guidelines of the American Society of Echocardiography 17. A plethoric IVC is defined as a diameter greater than 21 mm 16…”

Section: Diagnosismentioning

confidence: 99%

“…To assess this characteristic, it is recommended to use all available imaging windows, particularly the four-chamber apical window and the short-axis subxiphoid window. 16 The earliest echocardiographic sign of tamponade is the collapse of the right atrium during systole, which occurs due to the lowest pressures in this cardiac chamber throughout the cardiac cycle. This sign is best visualized in the fourchamber view and can also be assessed in the long-axis subxiphoid window (SXLA).…”

Section: Diagnosismentioning

confidence: 99%

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Decoding Pericardial Effusion: Ultrasonographic Insights for Radiologists

Restrepo,

Franco,

Pérez

et al. 2023

Contemporary Diagnostic Radiology

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Pericardial effusion is a common finding in clinical practice. It can present incidentally asymptomatically or as a manifestation of systemic or cardiac disease. According to its commitment, it can be classified into mild effusions, generally asymptomatic, up to cardiac tamponade, which can endanger the patient's life. Recent advances make it possible to establish the presence and assess the size of the pericardial effusion, its hemodynamic impact, and clarify the etiology. The aim of this article is to provide an update on the diagnostic and therapeutic approach to pericardial effusion.

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“…It usually presents as an obstructive shock due to rapid accumulation of pericardial effusion which can be relieved immediately by pericardiocentesis. 1 , 2 However, intercurrent mediastinal space-occupying pathologies may also play a role in the mechanism of cardiac tamponade. 3 , 4 The management of such patients with overlapping conditions remains debatable, and the literature are limited to case reports.…”

Section: Introductionmentioning

confidence: 99%

Worsening cardiac tamponade after pericardiocentesis in a patient with anterior mediastinum mass: a case report

Adi

Fong

Ahmad

et al. 2022

European Heart Journal - Case Reports

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Mediastinal mass is an entity with variable pathology and clinical spectrum. Anterior mediastinal mass can result in severe symptoms due to involvement of surrounding vital structures such as the great vessels, trachea-bronchial tree, and heart. We highlight a case of cardiac tamponade in a patient with an anterior mediastinal mass that was paradoxically worsened after decompressive pericardiocentesis. A 21-year-old male presented to the emergency department (ED) with breathlessness and hypotension. Bedside focused cardiac ultrasound revealed cardiac tamponade which was made worse with an anterior mediastinal mass compressing the right heart chambers. The patient was intubated for respiratory failure, following which an ultrasound-guided pericardiocentesis was performed. Unexpectedly, his hemodynamic status worsened after aspiration of 1000 ml of pericardial fluid. A repeat focused cardiac ultrasound showed reduced pericardial effusion, but worsening of right heart chambers compression by the mediastinal mass. Re-expansion of the pericardium space with 600 ml of normal saline improved the patient’s vital signs, and reduced the right heart compression. CT was deferred due to the patient’s hemodynamic instability. Despite resuscitation with fluids and initiation of vasopressor, the patient’s condition deteriorated. He succumbed to his illness due to obstructive shock causing multi-organ failure. The autopsy showed a large anterior mediastinal mass, and histopathological examination confirmed the diagnosis of lymphoma. This case demonstrated the therapeutic challenges of managing a shock patient with anterior mediastinal mass, and massive pericardial effusion causing cardiac tamponade.

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Pericardial tamponade: A comprehensive emergency medicine and echocardiography review

Cited by 51 publications

References 200 publications

Review of Hematology-Oncology Emergencies for Internal Medicine Residents

Review of Hematology-Oncology Emergencies for Internal Medicine Residents

Decoding Pericardial Effusion: Ultrasonographic Insights for Radiologists

Worsening cardiac tamponade after pericardiocentesis in a patient with anterior mediastinum mass: a case report

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