Protocolo diagnóstico y diagnóstico diferencial del taponamiento cardiaco

Abstract

Cardiac tamponade is a medical emergency caused by compression of the heart due to pericardial effusion. This fluid accumulation in the intrapericardial space raises the pressure surrounding the heart to the point where cardiac filling is altered. This syndrome is understood as a continuum and its manifestations range from a slight increase in intrapericardial pressure with minimal repercussion on cardiac function to severe hemodynamic compromise that may even be fatal. The severity of tamponade depends on speed of fluid accumulation. The clinical diagnosis is essential. Signs of cardiac tamponade are: low cardiac output and elevated jugular venous pressure, as well as reactive vasoconstriction and tachycardia. Often physical diagnosis should be completed with other diagnostic tests as electrocardiography, chest radiography and echocardiography. This imaging technique is an important tool for evaluating patients with cardiac tamponade. Echocardiography allows to confirm the presence, location, distribution and size of the pericardial effusion, as well as to assess its hemodynamic consequences and the need for pericardiocentesis. Cardiac magnetic resonance imaging (CMR) and computed tomography (CT) are other imaging modalities which may help accurate diagnosis.