Document Detail


Cardiac tamponade.
MedLine Citation:
PMID:  21716107     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: To re-emphasize the epidemiology, pathophysiology, diagnosis, and treatment of cardiac tamponade. RECENT FINDINGS: Cardiac tamponade is a cause of obstructive shock. Incidence of cardiac tamponade is poorly documented. In cardiac tamponade, the pericardial pressure may reach 15-20 mmHg, leading to an equalization of pressures into the cardiac chambers and to a huge decrease in the systemic venous return. The right atrial transmural pressure becomes negligible. A competition between the right atrium and the right ventricle and between both ventricles is occurring. Deep inspiration allows the patients to maintain the systemic venous return at a certain level. Echocardiography is the key tool to diagnose a pericardial effusion, to detect its bad-tolerance, and to guide the treatment. In some situations following cardiac surgery, transesophageal echocardiography is mandatory. Treatment aims to restore a 'normal' blood pressure by fluid loading (with caution) and catecholamines and to drain the pericardium in emergency. SUMMARY: Cardiac tamponade is responsible for an obstructive shock. Causes of pericardial effusion are numerous. Echocardiography is the fundamental tool for the diagnosis and therapeutic management. Volume resuscitation and catecholamines are temporary treatments, pericardial drainage remaining the only effective treatment.
Authors:
Laurent Bodson; Koceïla Bouferrache; Antoine Vieillard-Baron
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-29
Journal Detail:
Title:  Current opinion in critical care     Volume:  -     ISSN:  1531-7072     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-6-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
ICU, Section Thorax - Vascular Diseases - Abdomen - Metabolism, University Hospital Ambroise Paré, Boulogne and Faculté de Médecine Paris Ile de France Ouest, Université de Versailles Saint Quentin en Yvelines, Versailles, France.
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