Pericardial Tamponade

Always consider pericardial effusions in patients with low voltage and tachycardia. Especially if low voltage is new!

Electrical alternans is “classic” …so don’t rely on it! (Only seen in <1/3 of cases).

Avoid anticoagulants/lytics until pericardial effusion is ruled out. Large pericardial effusions often are misdiagnosed as ACS and PE!