Cardiac tamponade

Thanks to Dr. Parker for taking us through some really interesting echocardiographic findings in a patient with cardiac tamponade.

Tamponade occurs when the intrapericardial pressure rises to the point where it compromises venous filling of the right atrium, which can actually be seen to collapse on echocardiogram. Impaired blood flow to the right side of the heart means less blood to go to the left side, exacerbated by the RV's attempt to expand in a compressed space which leads to interventricular bulging into the LV. This decreased LV filling results in the clinical findings of hypotension and pulsus paradoxus. Acute tamponade is immediately life-threatening and will require pericardiocentesis - get an echo and a cardiology consult!!!

See here for a recent review of pericardial diseases.