Cardiac tamponade physical examination: Difference between revisions
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** [[Hypotension]] occurs because of decreased [[stroke volume]] | ** [[Hypotension]] occurs because of decreased [[stroke volume]] | ||
** [[jugular venous distension]] due to impaired venous return to the heart, and | ** [[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> | ** 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> | ||
===General examination=== | ===General examination=== | ||
Revision as of 14:47, 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.
Overview
Physical examination may vary depending on the type of cardiac tamponade. Physical examination may show the classic Beck's triad (hypotension, muffled heart sound, and elevated jugular venous distension), tachycardia, pulsus paradoxus, and pericardial rub depending on the type, and severity of tamponade. Initial diagnosis can be challenging, as there are a number of differential diagnoses, including Tension pneumothorax [1], and acute heart failure.
Physical Examination
Vital signs
- Sinus tachycardia
- 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]
General examination
- Altered sensorium (decreasing level of consciousness)
- Dimished peripheral pulses
Cardiovascular
- Beck's triad (see vital signs)
Auscultation
- Pulsus paradoxsus (a drop of > 10 mmHg in arterial blood pressure on inspiration) [4].
- Preicardial rub
- Diminished 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