TY - CHAP M1 - Book, Section TI - Percardial Effusion and Tamponade A1 - Burstow, Darryl J. A1 - Luis, Sushil Allen A1 - Kane, Garvan C. A1 - Oh, Jae K. A2 - Fuster, Valentin A2 - Narula, Jagat A2 - Vaishnava, Prashant A2 - Leon, Martin B. A2 - Callans, David J. A2 - Rumsfeld, John S. A2 - Poppas, Athena PY - 2022 T2 - Fuster and Hurst's The Heart, 15e AB - Chapter SummaryThis chapter outlines the etiology, clinical presentation, investigation, and management of pericardial effusions and cardiac tamponade (see Fuster and Hurst’s Central Illustration). Pericardial effusions are most commonly idiopathic in etiology in developed countries, while tuberculous pericarditis is the predominant etiology in developing countries. Cardiac tamponade results when intrapericardial pressure elevation impairs cardiac filling with resulting hemodynamic derangements. The rate of pericardial fluid accumulation is a key factor in the development of cardiac tamponade, whereby small volume rapidly accumulating pericardial effusions can result in cardiac tamponade. Clinical evaluation of patients with pericardial effusions should assess for features of cardiac tamponade, including symptoms, tachycardia, hypotension, pulsus paradoxus, and jugular venous pressure elevation. Transthoracic echocardiography is the key diagnostic test in the evaluation of pericardial effusions and assessment of cardiac tamponade, and should be performed in patients with suspected cardiac tamponade. Management of pericardial effusions should target the underlying etiology, with utilization of anti-inflammatory therapy in those with evidence of active pericardial inflammation. Amongst patients with cardiac tamponade, pericardiocentesis is the intervention of choice and should ideally be performed under imaging guidance. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessmedicine.mhmedical.com/content.aspx?aid=1202455886 ER -