- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Part 5.1 Physiology
- Part 5.2 Cardiovascular monitoring
- Part 5.3 Acute chest pain and coronary syndromes
- Part 5.4 Aortic dissection
- Part 5.5 The hypotensive patient
- Part 5.6 Cardiac failure
- Part 5.7 Tachyarrhythmias
- Part 5.8 Bradyarrhythmias
- Part 5.9 Valvular problems
- Part 5.10 Endocarditis
- Part 5.11 Severe hypertension
- Part 5.12 Severe capillary leak
- Part 5.13 Pericardial tamponade
- Chapter 166 Pathophysiology and causes of pericardial tamponade
- Chapter 167 Management of pericardial tamponade
- Part 5.14 Pulmonary hypertension
- Part 5.15 Pulmonary embolus
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care
(p. 779) Pericardial tamponade
Pericardial disease leading to pericardial effusion (PEF) is a common clinical disorder. The most common causes are viral infections, metastatic cancer, renal disease, and bleeding disorders. PEF that accumulates slowly can become quite large before haemodynamic embarrassment occurs, while PEF that accumulates rapidly from trauma or aortic dissection can be small,yet cause haemodynamic embarrassment. As the PEF increases in size, the pressure in the pericardial space increases, leading to a decrease in atrial and ventricular chamber sizes, and limiting filling of the chambers. Ultimately, cardiac output is decreased,resulting in cardiac tamponade. When the limits of the pericardial stretch are reached, the volume in the pericardial sac becomes fixed. Any additional increase of PEF results in decreased cardiac size and any change in chamber size with respiration results in a paradoxical change in size of the other chambers. Tamponade is divided into three phases based on changes in pericardial and arterial pressure and cardiac output. Doppler echocardiography is the cornerstone of the diagnosis, follow-up, and management of PEF. It provides information about the presence, size, and location of the PEF, its impact on right ventricle, right atrium, and inferior vena cava size, and assesses tamponade physiology. Comorbid conditions may modify the signs of tamponade and need to be considered during the clinical assessment. Tamponade is not an all-or-nothing diagnosis, but instead should be viewed along a continuum of progressively worsening haemodynamics.
Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.
Please subscribe or login to access full text content.
If you have purchased a print title that contains an access token, please see the token for information about how to register your code.
For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.
- Section 1 ICU organization and management
- Section 2 Pharmacotherapeutics
- Section 3 Resuscitation
- Section 4 The respiratory system
- Section 5 The cardiovascular system
- Part 5.1 Physiology
- Part 5.2 Cardiovascular monitoring
- Part 5.3 Acute chest pain and coronary syndromes
- Part 5.4 Aortic dissection
- Part 5.5 The hypotensive patient
- Part 5.6 Cardiac failure
- Part 5.7 Tachyarrhythmias
- Part 5.8 Bradyarrhythmias
- Part 5.9 Valvular problems
- Part 5.10 Endocarditis
- Part 5.11 Severe hypertension
- Part 5.12 Severe capillary leak
- Part 5.13 Pericardial tamponade
- Chapter 166 Pathophysiology and causes of pericardial tamponade
- Chapter 167 Management of pericardial tamponade
- Part 5.14 Pulmonary hypertension
- Part 5.15 Pulmonary embolus
- Section 6 The gastrointestinal system
- Section 7 Nutrition
- Section 8 The renal system
- Section 9 The neurological system
- Section 10 The metabolic and endocrine systems
- Section 11 The haematological system
- Section 12 The skin and connective tissue
- Section 13 Infection
- Section 14 Inflammation
- Section 15 Poisoning
- Section 16 Trauma
- Section 17 Physical disorders
- Section 18 Pain and sedation
- Section 19 General surgical and obstetric intensive care
- Section 20 Specialized intensive care
- Section 21 Recovery from critical illness
- Section 22 End-of-life care