Pericardial fluid accumulation impairs diastolic filling.
Causes
- • Malignancy, uraemia, TB
- • Post-MI (free wall rupture)
- • Trauma, aortic dissection
- • Post-cardiac surgery/procedure
Clinical features
- • Dyspnoea, hypotension
- • Beck's triad: hypotension, muffled sounds, raised JVP
- • Pulsus paradoxus >10 mmHg
Investigations
- • Bedside echo (RV diastolic collapse)
- • ECG (low voltage, electrical alternans)
- • CXR (globular heart)
Management
- • IV fluid 500 mL bridge
- • Urgent pericardiocentesis (echo-guided subxiphoid)
- • Avoid PEEP, vasodilators, diuretics
- • Treat cause
Related in WardRound
Educational — verify locally.
