Derrame pericárdico. Taponamiento cardíaco

Abstract

IntroductionPericardial effusion is defined as the non-physiological presence of fluid in the pericardial sac. When increased intrapericardial pressure restricts the effective filling of the heart cavities this causes the serious haemodynamic situation of cardiac tamponade. AetiologyIn our environment, the principal cause of pericardial effusion is idiopathic. Cardiac taponade can develop in the event of a pericardial effusion of any origin. Clinical manifestationsThe symptoms associated with pericardial effusion are secondary to mechanical compression of the neighbouring structures. The main clinical signs that a patient with cardiac taponade can present are tachycardia, arterial hypotension, increased jugular vein pressure, diminished heart sounds and pulsus paradoxus. DiagnosisTransthoracic echocardiogram is the diagnostic test of choice for both conditions. TreatmentTreatment of pericardial effusion depends on its aetiology. Emergency drainage of the pericardial fluid is recommended by means of percutaneous pericardiocentesis or surgical drainage to treat the cardiac taponade.