Cardiac tamponade
Cardiac tamponade Dx:
- Sudden cessation of significant mediastinal bleeding.
- low CO, hypotension, narrow pulse pressure, respiratory variation.
- equilibration of intracardiac pressures: R. atrial - PCW = L. atrial
- CXR: widened mediastinum, displaced R. heart border (suggests a clot adjacent to R. atrium)
- tachycardia
- dysrhythmia
- low ECG amplitude
- PEA
- No improvement in hemodynamics despite volume infusions and inotropic support
- echocardiography - TEE better (R. or L. ventricular diastolic collapse is a reliable sign)