Cardiac tamponade | Beck's Triad | Cardiac Surgery | FULLY EXPLAINED


Rapid accumulation of fluid or blood in the pericardial space causing increase in the intrapericardial pressure is called as cardiac tamponade. This results in 

Compression of cardiac chambers.
↓
↓ venous return
↓
↓ cardiac output

Causes

  • Trauma 
  • Progressive pericardial effusion due to tuber­culosis, viral, bacterial infections
  • Often, uraemia can cause significant pericardial effusion

Features  

  • Hypotension. 
  • Widened cardiac dullness. 
  • Muffled or decreased heart sounds. 
  • Increased venous pressure with raised jugular veins. 
  • Pulsus paradoxus (pulse becomes weaker on inspiration than expiration).
  • In severe cases, heart is unable to expand causing shock and often sudden death.

Beck’s triad

  • Hypotension 
  • Muffled heart sounds
  • Raised jugular venous pressure

Investigation

  • Chest X-ray and 
  • US confirms the diagnosis. 

Differential diagnosis: 

Tension pneumothorax.

Treatment

  • Pericardial tap is done for immediate temporary relief under US guidance—needle pericardiocentesis.
  • But eventual open pericardiotomy (occasionally pericardiectomy) and drainage is required in most of the patients.

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