Cardiac Tamponade Signs | Medical Algorithm

Cardiac tamponade may present with a number of clinical findings, the progression of which depends on how rapidly the pericardial fluid accumulates.

Clinical findings:

(1) chest pain or a feeling of heaviness

(2) syncope

(3) palpitations

(4) dyspnea, especially on exertion

(5) tachypnea

(6) fatigue

Physical findings - classic "triad":

(1) hypotension

(2) tachycardia (pulse > 90 beats per minute, which may be absent in uremia or hypothyroidism)

(3) muffled heart sounds

Additional findings:

(4) pulsus paradoxicus

(5) distended jugular and retinal veins

(6) pericardial rub

If the intrapericardial pressure becomes high enough to seriously impair cardiac output, then signs of low output (cardiogenic) shock develop with:

(1) cold and clammy skin

(2) oliguria

(3) altered mental status

(4) peripheral cyanosis

(5) severe hypotension

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Clinical Features of Cardiac Tamponade