Cardiac tamponade/Physical examination

Jump to navigation Jump to search

Page has default form::MedicalTest {{#meta: itemprop="medicalWebPageAudiences" content="patient"}}{{#meta: itemprop="medicalWebPageSpecialities" content="cardiology"}}{{#meta: itemprop="medicalWebPageInfoTypes" content="symptoms,diagnosis,treatment,causes,prognosis,complications"}}



Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Varun Kumar, M.B.B.S.

Overview

Cardiac tamponade Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cardiac Tamponade from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Case Studies

Case #1

Cardiac tamponade/Physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Google Images

American Roentgen Ray Society Images of Cardiac tamponade/Physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Cardiac tamponade/Physical examination

CDC on Cardiac tamponade/Physical examination

Cardiac tamponade/Physical examination in the news

Blogs on Cardiac tamponade/Physical examination

Directions to Hospitals Treating Type page name here

Risk calculators and risk factors for Cardiac tamponade/Physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [4]; Varun Kumar, M.B.B.S.; Ahmed Zaghw, M.D. [5] Ramyar Ghandriz MD[6]

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, and acute heart failure.

Physical Examination

Appearance of the Patient

The American thoracic surgeon, Beck, has described two clinical triad in 1930. The clinical triads are for both cardiac tamponade and pericardial constriction.

Beck's Triad for Tamponade Beck's Triad Pericardial Constriction
Hypotension (due to decreased stroke volume) Ascites
Jugular venous distension (due to impaired venous return to the heart) High venous pressure
Muffled heart sounds (due to fluid inside the pericardium) [3] Small quiet heart

It should be noted that Beck's triad was descriped for the tamponade casued by acute intrapericardial hemorrhage, eg, traumatic causes of tamponade. This may not apply to other more slowly progressive forms of tamponade associated with a variety of medical conditions as opposed to surgical causes.[4]

Vital Signs

Skin

  • Skin examination of patients with cardiac tamponade is usually normal.

HEENT

  • HEENT examination of patients with cardiac tamponade is usually normal.

Neck

Lungs

  • Pulmonary crackles may be heared due to acute pulmonary edema.

Cardiovascular

Auscultation

In addition to the Beck's triad and pulsus paradoxus the following can be found on cardiovascular examination:

  • Pericardial rub
  • Clicks - As Ventricular volume shrinks disproportionately, there may be psuedoprolapse/true prolapse of mitral and/or tricuspid valvular structures that result in clicks.
  • Kussmaul's sign - Decrease in jugular venous pressure with inspiration is uncommon.

Pulsus Paradoxus

The following video depicts and explains the concept of pulsus paradoxus. {{#ev:youtube|jTsjCZ9QxW8}}

Abdomen

  • Abdominal examination of patients with cardiac tamponade is usually normal.

Back

  • Back examination of patients with cardiac tamponade is usually normal.

Genitourinary

  • Genitourinary examination of patients with cardiac tamponade is usually normal.

Neuromuscular

  • Neuromuscular examination of patients with cardiac tampnoade is usually normal.

Extremities

  • Extremities examination of patients with cardiac tamponade is usually normal.

References

  1. Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097
  2. Gwinnutt, C., Driscoll, P. (Eds) (2003) (2nd Ed.) Trauma Resuscitation: The Team Approach. Oxford: BIOS Scientific Publishers Ltd. ISBN 978-1859960097
  3. Dolan, B., Holt, L. (2000). Accident & Emergency: Theory into practice. London: Bailliere Tindall ISBN 978-0702022395
  4. Guberman, BA.; Fowler, NO.; Engel, PJ.; Gueron, M.; Allen, JM. (1981). "Cardiac tamponade in medical patients". Circulation. 64 (3): 633–40. PMID 6455217. Unknown parameter |month= ignored (help)

Template:WS Template:WH CME Category::Cardiology

Related Pages