Pericardial Effusion & Tamponade

Exam Cram

• Pericardial effusion causing haemodynamic instability

• Examination: muffled heart sounds, pulsus paradoxus, raised JVP, tachycardia, hypotension

• Diagnose: ECHO

• Management: pericardiocentesis 

Pericardial Tamponade

• Core signs: short of breath, tachycardia, elevated JVP

• O/E: muffled heart sounds, 

• Rarely signs: pulsus paradoxus, Kussmaul's sign

• Diagnosis: ECHO

• Management: pericardiocentesis depending upon sign and cardiovascular compromise

Pulsus paradoxus

• Blood pressure normally falls on inspiration

• In pulsus paradoxus it falls further, > 12mmhg

• Associated with asthma and pericardial tamponade 

• If present, a sign that the effusion requires drainage

Kussmaul's sign

• • Normally JVP falls with inspiration

  • Kussmaul's sign: JVP rises with inspiration

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