Cardiac tamponade

We discussed a case about a middle aged woman with subacute-chronic SOB, fatigue, pleuritic CP, and productive cough, found to have a large pericardial effusion with features of cardiac tamponade. We learned about various features of cardiac tamponade:

  •  Exam: Beck’s triad, pulsus paradoxus
  • EKG: low voltage QRS, tachycardia, electrical alternans
  • TTE / POCUS
    • Cardiac chamber collapse
    • Dilated IVC
    • Reciprocal respiratory variations in ventricular volumes
  • Pericardial vs pleural effusion on POCUS peristernal long axis (PLAX)
    • Pericardial: fluid ANTERIOR to the descending aorta
    • Pleural: fluid POSTERIOR to the descending aorta

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