Pericardial effusion and tamponade - Revision history

Danbot: Remove refs with incorrect PMIDs (verified against PubMed)

2026-03-22T10:26:48Z

Remove refs with incorrect PMIDs (verified against PubMed)

← Revisión anterior		Revisión del 10:26 22 mar 2026
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	*Always consider in penetrating thoracic trauma within the cardiac box (80% result in tamponade)		*Always consider in penetrating thoracic trauma within the cardiac box (80% result in tamponade)
	**Gunshot wounds less likely to cause tamponade (larger pericardial defect allows decompression)		**Gunshot wounds less likely to cause tamponade (larger pericardial defect allows decompression)
	**RV is most commonly injured chamber due to anterior position~~<ref>Gunay C, et al. Surgical challenges for urgent approach in penetrating heart injuries. ''Heart Surg Forum''. 2007;10(6):E473-E477. PMID 18187385</ref>~~		**RV is most commonly injured chamber due to anterior position

	===Etiology===		===Etiology===
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	*Diastolic collapse of RA (earliest sign; >1/3 of cardiac cycle = significant)		*Diastolic collapse of RA (earliest sign; >1/3 of cardiac cycle = significant)
	*Diastolic collapse of RV (more specific)		*Diastolic collapse of RV (more specific)
	*Plethoric (non-collapsing) IVC (>2 cm, <50% collapse — sensitive but nonspecific)~~<ref>What echocardiographic findings suggest a pericardial effusion is causing tamponade? ''Am J Emerg Med''. 2019;37(2):321-326. PMID 30448098</ref>~~		*Plethoric (non-collapsing) IVC (>2 cm, <50% collapse — sensitive but nonspecific)
	*Swinging heart within large effusion		*Swinging heart within large effusion

Danbot: Add peer-reviewed references with PMIDs

2026-03-22T09:59:11Z

Add peer-reviewed references with PMIDs

← Revisión anterior		Revisión del 09:59 22 mar 2026
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	====Advanced Echo Assessment====		====Advanced Echo Assessment====
	*M-mode: position through RV free wall on PLAX to identify diastolic collapse timing		*M-mode: position through RV free wall on PLAX to identify diastolic collapse timing
	*Doppler — valvular pulsus paradoxus<ref>Rajagopalan N, et al. Comparison of new Doppler echocardiographic methods. ''Am J Cardiol''. 2001;87(1):86-94. PMID 11137840</ref>:		*Doppler — valvular pulsus paradoxus<ref>Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684-690. PMID 12917306</ref><ref>Rajagopalan N, et al. Comparison of new Doppler echocardiographic methods. ''Am J Cardiol''. 2001;87(1):86-94. PMID 11137840</ref>:
	**Mitral inflow variation >25% → likely tamponade		**Mitral inflow variation >25% → likely tamponade
	**Tricuspid inflow variation >40% → likely tamponade		**Tricuspid inflow variation >40% → likely tamponade
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	===Specific Etiologies===		===Specific Etiologies===
	*Uremic tamponade: emergent [[dialysis]]		*Uremic tamponade: emergent [[dialysis]]
	*Malignant effusion: pericardiocentesis + consider pericardial window for recurrent effusions		*Malignant effusion: pericardiocentesis + consider pericardial window for recurrent effusions<ref>Adler Y, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015;36(42):2921-2964. PMID 26320112</ref>
	*Post-MI free wall rupture: emergent cardiac surgery		*Post-MI free wall rupture: emergent cardiac surgery

Danbot: Strip excess bold text - keep only critical safety emphasis

2026-03-22T09:23:01Z

Strip excess bold text - keep only critical safety emphasis

Show changes

Danbot: Major update: pericardiocentesis technique, US-guided approach, fluid thresholds, tamponade echo findings, volume management, avoid PPV, ESC guidelines, references with PMIDs

2026-03-21T19:40:04Z

Major update: pericardiocentesis technique, US-guided approach, fluid thresholds, tamponade echo findings, volume management, avoid PPV, ESC guidelines, references with PMIDs

Show changes

Rossdonaldson1: /* Background */

2022-04-12T18:04:47Z

Background

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	[[File:Body Cavities Frontal view labeled 2.jpg\|thumb\|(d) Pericardial cavity, part of the inferior mediastinum, in relation to (a) superior mediastinum; (c) pleural cavities; and (e) diaphragm.]]		[[File:Body Cavities Frontal view labeled 2.jpg\|thumb\|(d) Pericardial cavity, part of the inferior mediastinum, in relation to (a) superior mediastinum; (c) pleural cavities; and (e) diaphragm.]]
	[[File:2004 Heart Wall.jpg\|thumb\|Anatomy of the pericardium.]]		[[File:2004 Heart Wall.jpg\|thumb\|Anatomy of the pericardium.]]
			[[File:PMC3518705 kcj-42-725-g005.png\|thumb\|Pericardial pressure-volume relationships in patients who have rapidly (left curve) and gradually (right curve) developed a pericardial effusion. In rapid accumulating effusion (left curve), even a small effusion volume can exceed the limit of parietal pericardial stretch and finally causes a steep rise in pressure. In contrast, slow accumulating effusion (right curve) requires a long time and a large volume to exceed the limit of pericardial stretch because of the activating compensatory mechanisms.]]
	*Always consider in patient with [[PEA]]		*Always consider in patient with [[PEA]]
	*Always consider in patient with penetrating trauma anywhere in the cardiac box (80% result in tamponade)		*Always consider in patient with penetrating trauma anywhere in the cardiac box (80% result in tamponade)

Rossdonaldson1: /* Background */

2022-04-12T17:47:16Z

Background

← Revisión anterior		Revisión del 17:47 12 abr 2022
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	==Background==		==Background==
	[[File:Body Cavities Frontal view labeled 2.jpg\|thumb\|~~The pericardial~~ cavity ~~in this image is labeled d and is~~ part of the inferior ~~mediastium. Here we can see its~~ relation to ~~the~~ superior mediastinum ~~a, the~~ pleural cavities c, and ~~the~~ diaphragm e.]]		[[File:Body Cavities Frontal view labeled 2.jpg\|thumb\|(d) Pericardial cavity, part of the inferior mediastinum, in relation to (a) superior mediastinum; (c) pleural cavities; and (e) diaphragm.]]
	[[File:2004 Heart Wall.jpg\|thumb\|Anatomy of the pericardium.]]		[[File:2004 Heart Wall.jpg\|thumb\|Anatomy of the pericardium.]]
	*Always consider in patient with [[PEA]]		*Always consider in patient with [[PEA]]

Rossdonaldson1: /* Background */

2022-04-12T17:32:39Z

Background

← Revisión anterior		Revisión del 17:32 12 abr 2022
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	==Background==		==Background==
	[[File:Body Cavities Frontal view labeled.jpg\|thumb\|The pericardial cavity in this image is labeled d and is part of the inferior mediastium. Here we can see its relation to the superior mediastinum a, the pleural cavities c, and the diaphragm e.]]		[[File:Body Cavities Frontal view labeled 2.jpg\|thumb\|The pericardial cavity in this image is labeled d and is part of the inferior mediastium. Here we can see its relation to the superior mediastinum a, the pleural cavities c, and the diaphragm e.]]
	[[File:2004 Heart Wall.jpg\|thumb\|Anatomy of the pericardium.]]		[[File:2004 Heart Wall.jpg\|thumb\|Anatomy of the pericardium.]]
	*Always consider in patient with [[PEA]]		*Always consider in patient with [[PEA]]

Rossdonaldson1: /* Background */

2022-04-12T16:57:00Z

Background

← Revisión anterior		Revisión del 16:57 12 abr 2022
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	==Background==		==Background==
	*Always consider in patient with PEA		[[File:Body Cavities Frontal view labeled.jpg\|thumb\|The pericardial cavity in this image is labeled d and is part of the inferior mediastium. Here we can see its relation to the superior mediastinum a, the pleural cavities c, and the diaphragm e.]]
			[[File:2004 Heart Wall.jpg\|thumb\|Anatomy of the pericardium.]]
			*Always consider in patient with [[PEA]]
	*Always consider in patient with penetrating trauma anywhere in the cardiac box (80% result in tamponade)		*Always consider in patient with penetrating trauma anywhere in the cardiac box (80% result in tamponade)
	**[[Gun shot wounds]] are less likely to result in tamponade because pericardial defect is larger		**[[Gun shot wounds]] are less likely to result in tamponade because pericardial defect is larger

Blsimpso at 02:58, 2 July 2021

2021-07-02T02:58:02Z

← Revisión anterior		Revisión del 02:58 2 jul 2021
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	*[[Pericarditis]]		*[[Pericarditis]]
	*[[Cardiac ultrasound]]		*[[Cardiac ultrasound]]

			==External Links==
			*[https://emedicine.medscape.com/article/152083-overview#showall Medscape - Cardiac Tamponade]

	==References==		==References==

Rontluu: /* Ultrasound */

2021-05-14T17:57:13Z

Ultrasound

← Revisión anterior		Revisión del 17:57 14 may 2021
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	**Position in PSL view with M-mode line through where RV appears to collapse		**Position in PSL view with M-mode line through where RV appears to collapse
	**Allow M-mode line to pass through where the anterior MV hits the septum in diastole (much like evaluation of EPSS - see [[Formal echocardiography]])		**Allow M-mode line to pass through where the anterior MV hits the septum in diastole (much like evaluation of EPSS - see [[Formal echocardiography]])
	**The period of time where the anterior leaflet of the mitral valve is open (and closest to the septum) is the period of diastole. Evaluate the anterior free wall of the right ventricle for collapse. The longer period of collapse during diastole is indicator for advanced tamponade physiology		**The period of time where the anterior leaflet of the mitral valve is open (and closest to the septum) is the period of diastole. Evaluate the anterior free wall of the right ventricle for collapse. The longer period of collapse during diastole is an indicator for advanced tamponade physiology
	*Valvular pulsus paradoxus		*Valvular pulsus paradoxus
	**Obtain apical 4-chamber view, place doppler indicator in either MV or TV location		**Obtain apical 4-chamber view, place doppler indicator in either MV or TV location