Cardiac tamponade physical examination: Difference between revisions
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Classical cardiac tamponade presents three signs, known as [[Beck's triad]]<ref>Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097 </ref>. [[Hypotension]] occurs because of decreased [[stroke volume]], [[jugular venous distension]] due to impaired venous return to the heart, and muffled [[heart sounds]] due to fluid inside the pericardium <ref>Dolan, B., Holt, L. (2000). Accident & Emergency: Theory into practice. London: Bailliere Tindall ISBN 978-0702022395</ref> Another sign of tamponade on physical examination includes [[pulsus paradoxus]] (a drop of at least 10 mmHg in arterial blood pressure on inspiration) <ref>Mattson Porth, C. (Ed.) (2005) (7th Ed.) Pathophysiology: Concepts of Altered Health States. Philadelphia : Lippincott Williams & Wilkins ISBN 978-0781749886 </ref>. There may also be general signs & symptoms of cardiogenic [[shock]] (such as [[tachycardia]], [[breathlessness]], poor perfusion of the extremities and decreasing [[Glasgow coma scale|level of consciousness]]). [[Peripheral edema]] may be present. Hemodynamic changes diminish S<sub>1</sub> and S<sub>2</sub> . As Ventricular volume shrinks disproportionately, there may be psuedoprolapse/true prolapse of mitral and/or tricuspid valvular structures that result in clicks. | Classical cardiac tamponade presents three signs, known as [[Beck's triad]]<ref>Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097 </ref>. [[Hypotension]] occurs because of decreased [[stroke volume]], [[jugular venous distension]] due to impaired venous return to the heart, and muffled [[heart sounds]] due to fluid inside the pericardium <ref>Dolan, B., Holt, L. (2000). Accident & Emergency: Theory into practice. London: Bailliere Tindall ISBN 978-0702022395</ref> Another sign of tamponade on physical examination includes [[pulsus paradoxus]] (a drop of at least 10 mmHg in arterial blood pressure on inspiration) <ref>Mattson Porth, C. (Ed.) (2005) (7th Ed.) Pathophysiology: Concepts of Altered Health States. Philadelphia : Lippincott Williams & Wilkins ISBN 978-0781749886 </ref>. There may also be general signs & symptoms of cardiogenic [[shock]] (such as [[tachycardia]], [[breathlessness]], poor perfusion of the extremities and decreasing [[Glasgow coma scale|level of consciousness]]). [[Peripheral edema]] may be present. Hemodynamic changes diminish S<sub>1</sub> and S<sub>2</sub> . As Ventricular volume shrinks disproportionately, there may be psuedoprolapse/true prolapse of mitral and/or tricuspid valvular structures that result in clicks. | ||
==Pulsus paradoxsus== | |||
{{#ev:youtube|jTsjCZ9QxW8}} | |||
==References== | ==References== | ||
Revision as of 14:13, 14 September 2012
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.
Physical Examination
Initial diagnosis can be challenging, as there are a number of differential diagnoses, including Tension pneumothorax [1], and acute heart failure.
Classical cardiac tamponade presents three signs, known as Beck's triad[2]. Hypotension occurs because of decreased stroke volume, jugular venous distension due to impaired venous return to the heart, and muffled heart sounds due to fluid inside the pericardium [3] Another sign of tamponade on physical examination includes pulsus paradoxus (a drop of at least 10 mmHg in arterial blood pressure on inspiration) [4]. There may also be general signs & symptoms of cardiogenic shock (such as tachycardia, breathlessness, poor perfusion of the extremities and decreasing level of consciousness). Peripheral edema may be present. Hemodynamic changes diminish S1 and S2 . As Ventricular volume shrinks disproportionately, there may be psuedoprolapse/true prolapse of mitral and/or tricuspid valvular structures that result in clicks.
Pulsus paradoxsus
{{#ev:youtube|jTsjCZ9QxW8}}
References
- ↑ Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097
- ↑ Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097
- ↑ Dolan, B., Holt, L. (2000). Accident & Emergency: Theory into practice. London: Bailliere Tindall ISBN 978-0702022395
- ↑ Mattson Porth, C. (Ed.) (2005) (7th Ed.) Pathophysiology: Concepts of Altered Health States. Philadelphia : Lippincott Williams & Wilkins ISBN 978-0781749886