Cardiovascular - Cardiac Tamponade

In this episode, we review cardiac tamponade, a life-threatening condition caused by rapid accumulation of fluid within the pericardial sac leading to impaired ventricular filling and hemodynamic collapse. We discuss the underlying pathophysiology of rising intrapericardial pressure, common causes including malignancy, infection, autoimmune disease, uremia, trauma, and post-MI complications, and why the rate of fluid accumulation is often more important than the total volume. Clinical presentation, including dyspnea, chest pain, tachycardia, hypotension, and shock, is reviewed alongside classic exam findings such as Beck's triad and pulsus paradoxus. We also cover high-yield diagnostic findings on echocardiography, EKG, and chest imaging, as well as emergent management with pericardiocentesis and definitive treatment of the underlying cause. References Bushardt RL, Colomb-Lippa DM, Klinger AM, Reed H. The JAAPA QRS Review for PAs: Study Plan and Guide for PANCE and PANRE. 1st ed. LWW; 2021. ISBN: 9781975143817 Adler Y, Ristić AD, Imazio M, et al. Cardiac tamponade. Nature Reviews Disease Primers. 2023;9(1). doi:10.1038/s41572-023-00446-1 Spodick DH. Acute cardiac tamponade. New England Journal of Medicine. 2003;349(7):684-690. doi:10.1056/nejmra022643 Wang TK, Klein AL, Cremer PC, et al. 2025 concise clinical guidance: An ACC expert consensus statement on the diagnosis and management of pericarditis. JACC. 2025;86(25):2691-2719. doi:10.1016/j.jacc.2025.05.023