• Olcay AksoyEmail author
  • Begum Sezer
  • Leonardo Rodriguez
Part of the Contemporary Cardiology book series (CONCARD)


Pericardial effusion complicated by tamponade is an uncommon yet potentially life-threatening event. Progression of a pericardial effusion to tamponade depends on several parameters, including rate of fluid accumulation, intravascular volume status of the patient, and tensile properties of the pericardium and the myocardium. Prompt and accurate diagnosis guided by the use of echocardiography and hemodynamic assessment using a pulmonary artery catheter can be lifesaving. In this chapter, we will review the clinical presentation, hemodynamic findings, and treatment paradigms that should be utilized when tamponade is suspected.


Tamponade Hypotension Pericarditis Effusion 


  1. 1.
    Armstrong WF, Ryan T, Feigenbaum H. Feigenbaum’s echocardiography. 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2010. xv, 785p.Google Scholar
  2. 2.
    Kern MJ, Lim MJ. Hemodynamic rounds: interpretation of cardiac pathophysiology from pressure waveform analysis. 3rd ed. Hoboken: Wiley; 2009. xxii, 473p.Google Scholar
  3. 3.
    Reddy PS, Curtiss EI, Uretsky BF. Spectrum of hemodynamic changes in cardiac tamponade. Am J Cardiol. 1990;66(20):1487–91.CrossRefGoogle Scholar
  4. 4.
    Sagrista-Sauleda J, et al. Low-pressure cardiac tamponade: clinical and hemodynamic profile. Circulation. 2006;114(9):945–52.CrossRefGoogle Scholar
  5. 5.
    Curtiss EI, et al. Pulsus paradoxus: definition and relation to the severity of cardiac tamponade. Am Heart J. 1988;115(2):391–8.CrossRefGoogle Scholar
  6. 6.
    Sharkey SW. A guide to interpretation of hemodynamic data in the coronary care unit. Philadelphia: Lippincott-Raven; 1997. p. 214.Google Scholar
  7. 7.
    Stouffer GA, Inc E. Cardiovascular hemodynamics for the clinician. Malden: Blackwell Futura; 2008.Google Scholar
  8. 8.
    Restrepo CS, Lemos DF, Lemos JA, Velasquez E, Diethelm L, Ovella TA, Martinez S, Carrillo J, Moncada R, Klein JS. Imaging findings in cardiac tamponade with emphasis on CT. Radiographics. 2007;27:1525–610.Google Scholar
  9. 9.
    LeWinter MM. Pericardial diseases: In: Braunwald’s heart disease: a textbook of cardiovascular disease. Philadelphia: Saunders Elsevier; 2008. p. 1836 from original by “Lorell BH, Grossman W. Profiles in constrictive pericarditis, restrictive cardiomyopathy and cardiac tamponade. In: Baum DS, Grossman W, editors. Grossman’s cardiac catheterization, angiography, and intervention. Philadelphia: Lippincott Williams & Wilkins; 2000. p. 840”.Google Scholar
  10. 10.
    Spodick DH. Acute cardiac tamponade. N Engl J Med. 2003;349(7):684–90.CrossRefGoogle Scholar

Suggested Readings

  1. Appleton C. Cardiac tamponade. Cardiol Clin. 2017;35(4):525–37.CrossRefGoogle Scholar
  2. Maggiolini S, et al. The role of early contrast-enhanced chest computed tomography in the aetiological diagnosis of patients presenting with cardiac tamponade or large pericardial effusion. Eur Heart J Cardiovasc Imaging. 2016;17:421–8.CrossRefGoogle Scholar
  3. Ristic AD, et al. Triage strategy for urgent management of cardiac tamponade: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2014;35:2279–84.CrossRefGoogle Scholar
  4. Sánchez-Enrique C, et al. Cause and long-term outcome of cardiac tamponade. American J Cardiol. 2016;117(4):664–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.David Geffen School of MedicineUCLA Medical CenterLos AngelesUSA
  2. 2.UCLA Medical CenterLos AngelesUSA
  3. 3.Cleveland ClinicClevelandUSA

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