Frequent repeat examinations should be performed if the diagnosis is suspected since some key findings may be transient.
Clinical criteria - >= 2 of the following:
(1) typical chest pain (pleuritic chest pain that is relieved by sitting forward; pleuritic chest pain that radiates to the trapezius ridge)
(2) pericardial friction rub
(3) typical changes in the ECG
(4) pericardial effusion
The presence and size of an effusion can be measured by echocardiography or imaging scans. While a large effusion will usually enlarge the cardiac silhouette, a normal cardiac silhouette may be present with a smaller effusion.
Clinical features of cardiac tamponade:
(1) elevated jugular venous pressure
(2) muffled heart sounds
(3) hypotension
(4) paradoxical pulse (drop in pulse amplitude and systolic blood pressure during inspiration)
The clinical diagnosis also involves exclusion of conditions in the differential diagnosis such as pleurisy.
