TOC | Cardiology    CARDIAC TAMPONADE
See also Pericarditis  |  Pericardial Effusion

A. ETIOLOGIES                                    

  1. Infection: viral, bacterial, parasitic, fungal
  2. Systemic: uremia, various connective tissue disease as SLE, sarcoidosis
  3. Drug: Procainamide, Quinidine, hydralazine, ?Dilantin
  4. Myocardial infarction
  5. Radiation pericarditis
  6. Neoplasm: metastatic spread, primary pericardial tumor
  7. Postcardiac injury : after open heart surgery, chest trauma, Dressler's syndrome
  8. Hemopericardium: pacemaker perforation, anticoatulant Rx, ventricular rupture, pseudoaneurysm rupture, rupture of aneurysm of ascending aorta.

B. DIAGNOSIS:

C. TREATMENT:

  1. Emergency pericardiocentesis to remove the fluid, or Pericardiostomy (surgical opening of the pericardial sac - window)
  2. Avoid hypovolemia; may give IV fluid for hypotension as needed.
    The systemic arterial pressure & cardiac output may be supported by infusion of drugs such as dopamine, dobutamine, or isoproterenol.
  3. Specific treatment of the underlying cause.

     

08172003