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. 1997 Mar;73(857):141–145. doi: 10.1136/pgmj.73.857.141

Cardiac tamponade.

J B Ball 1, W L Morrison 1
PMCID: PMC2431271  PMID: 9135828

Abstract

Cardiac tamponade is a cardiological emergency requiring prompt treatment in order to avoid a fatal outcome. It can complicate a number of medical conditions and it is important, therefore, that all practitioners are aware of its presentation, diagnosis and management. These are outlined. We suggest that, with certain specific and important exceptions, percutaneous catheter pericardiocentesis is to be recommended in the management of cardiac tamponade. We include a review of 51 consecutive cases treated at our own institution. Catheter pericardiocentesis was successful in 49 (96%) cases and 36 (80%) patients did not require any further intervention. There were no major and only two minor complications which required no additional treatment. We review previous literature concerning percutaneous pericardiocentesis. Using recommended procedures, pericardiocentesis is successful in 90-100% of cases and major complications are rare.

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Selected References

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  1. BISHOP L. H., Jr, ESTES E. H., Jr, MCINTOSH H. D. The electrocardiogram as a safeguard in pericardiocentesis. J Am Med Assoc. 1956 Sep 22;162(4):264–265. doi: 10.1001/jama.1956.02970210004002. [DOI] [PubMed] [Google Scholar]
  2. Ball J. B., Morrison W. L. Experience with cardiac tamponade following open heart surgery. Heart Vessels. 1996;11(1):39–43. doi: 10.1007/BF01744598. [DOI] [PubMed] [Google Scholar]
  3. Callahan J. A., Seward J. B., Nishimura R. A., Miller F. A., Jr, Reeder G. S., Shub C., Callahan M. J., Schattenberg T. T., Tajik A. J. Two-dimensional echocardiographically guided pericardiocentesis: experience in 117 consecutive patients. Am J Cardiol. 1985 Feb 1;55(4):476–479. doi: 10.1016/0002-9149(85)90397-2. [DOI] [PubMed] [Google Scholar]
  4. Connors J. P., Kleiger R. E., Shaw R. C., Voiles J. D., Clark R. E., Harter H., Roper C. L. The indications for pericardiectomy in the uremic pericardial effusion. Surgery. 1976 Dec;80(6):689–694. [PubMed] [Google Scholar]
  5. FALLOWS J. A., PASTOR B. H. The use of a polyethylene catheter in pericardial paracentesis. N Engl J Med. 1955 Nov 17;253(20):872–873. doi: 10.1056/NEJM195511172532007. [DOI] [PubMed] [Google Scholar]
  6. Fredriksen R. T., Cohen L. S., Mullins C. B. Pericardial windows or pericardiocentesis for pericardial effusions. Am Heart J. 1971 Aug;82(2):158–162. doi: 10.1016/0002-8703(71)90260-2. [DOI] [PubMed] [Google Scholar]
  7. Glancy D. L., Richter M. A. Catheter drainage of the pericardial space. Cathet Cardiovasc Diagn. 1975;1(3):311–315. doi: 10.1002/ccd.1810010310. [DOI] [PubMed] [Google Scholar]
  8. Guberman B. A., Fowler N. O., Engel P. J., Gueron M., Allen J. M. Cardiac tamponade in medical patients. Circulation. 1981 Sep;64(3):633–640. doi: 10.1161/01.cir.64.3.633. [DOI] [PubMed] [Google Scholar]
  9. Jackson G., Keane D., Mishra B. Percutaneous balloon pericardiotomy in the management of recurrent malignant pericardial effusions. Br Heart J. 1992 Dec;68(6):613–615. doi: 10.1136/hrt.68.12.613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kilpatrick Z. M., Chapman C. B. On pericardiocentesis. Am J Cardiol. 1965 Nov;16(5):722–728. doi: 10.1016/0002-9149(65)90057-3. [DOI] [PubMed] [Google Scholar]
  11. Kopecky S. L., Callahan J. A., Tajik A. J., Seward J. B. Percutaneous pericardial catheter drainage: report of 42 consecutive cases. Am J Cardiol. 1986 Sep 15;58(7):633–635. doi: 10.1016/0002-9149(86)90290-0. [DOI] [PubMed] [Google Scholar]
  12. Krikorian J. G., Hancock E. W. Pericardiocentesis. Am J Med. 1978 Nov;65(5):808–814. doi: 10.1016/0002-9343(78)90800-8. [DOI] [PubMed] [Google Scholar]
  13. Kwasnik E. M., Koster K., Lazarus J. M., Sloss L. J., Mee R. B., Cohn L. H., Collins J. J. Conservative management of uremic pericardial effusions. J Thorac Cardiovasc Surg. 1978 Nov;76(5):629–632. [PubMed] [Google Scholar]
  14. MacAlpin R. N. Percutaneous catheter pericardiocentesis. Eur Heart J. 1980 Aug;1(4):287–291. doi: 10.1093/oxfordjournals.eurheartj.a061132. [DOI] [PubMed] [Google Scholar]
  15. Massumi R. A., Rios J. C., Ross A. M., Ewy G. A. Technique for insertion of an indwelling intrapericardial catheter. Br Heart J. 1968 May;30(3):333–335. doi: 10.1136/hrt.30.3.333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Morgan C. D., Marshall S. A., Ross J. R. Catheter drainage of the pericardium: its safety and efficacy. Can J Surg. 1989 Sep;32(5):331–334. [PubMed] [Google Scholar]
  17. Morin J. E., Hollomby D., Gonda A., Long R., Dobell A. R. Management of uremic pericarditis: a report of 11 patients with cardiac tamponade and a review of the literature. Ann Thorac Surg. 1976 Dec;22(6):588–592. doi: 10.1016/s0003-4975(10)64478-5. [DOI] [PubMed] [Google Scholar]
  18. Owens W. C., Schaefer R. A., Rahimtoola S. H. Pericardiocentesis: insertion of a pericardial catheter. Cathet Cardiovasc Diagn. 1975;1(3):317–321. doi: 10.1002/ccd.1810010311. [DOI] [PubMed] [Google Scholar]
  19. Palatianos G. M., Thurer R. J., Kaiser G. A. Comparison of effectiveness and safety of operations on the pericardium. Chest. 1985 Jul;88(1):30–33. doi: 10.1378/chest.88.1.30. [DOI] [PubMed] [Google Scholar]
  20. Pradhan D. J., Ikins P. M. The role of pericardiotomy in treatment of pericarditis with effusion. Am Surg. 1976 Apr;42(4):257–261. [PubMed] [Google Scholar]
  21. Ribot S., Frankel H. J., Gielchinsky I., Gilbert L. Treatment of uremic pericarditis. Clin Nephrol. 1974;2(4):127–130. [PubMed] [Google Scholar]
  22. SCHAFFER A. I. Pericardiocentesis with the aid of a plastic catheter and ECG monitor. Am J Cardiol. 1959 Jul;4(1):83–87. doi: 10.1016/0002-9149(59)90196-1. [DOI] [PubMed] [Google Scholar]
  23. SELDINGER S. I. Catheter replacement of the needle in percutaneous arteriography; a new technique. Acta radiol. 1953 May;39(5):368–376. doi: 10.3109/00016925309136722. [DOI] [PubMed] [Google Scholar]
  24. Silverberg S., Oreopoulos D. G., Wise D. J., Uden D. E., Meidok H., Jones M., Rapoport A., deVeber G. Pericarditis in patients undergoing long-term hemodialysis and peritoneal dialysis. Incidence, complications and management. Am J Med. 1977 Dec;63(6):874–879. doi: 10.1016/0002-9343(77)90540-x. [DOI] [PubMed] [Google Scholar]
  25. Susini G., Pepi M., Sisillo E., Bortone F., Salvi L., Barbier P., Fiorentini C. Percutaneous pericardiocentesis versus subxiphoid pericardiotomy in cardiac tamponade due to postoperative pericardial effusion. J Cardiothorac Vasc Anesth. 1993 Apr;7(2):178–183. doi: 10.1016/1053-0770(93)90213-5. [DOI] [PubMed] [Google Scholar]
  26. Wei J. Y., Taylor G. J., Achuff S. C. Recurrent cardiac tamponade and large pericardial effusions: management with an indwelling pericardial catheter. Am J Cardiol. 1978 Aug;42(2):281–282. doi: 10.1016/0002-9149(78)90911-6. [DOI] [PubMed] [Google Scholar]
  27. Wong B., Murphy J., Chang C. J., Hassenein K., Dunn M. The risk of pericardiocentesis. Am J Cardiol. 1979 Nov;44(6):1110–1114. doi: 10.1016/0002-9149(79)90176-0. [DOI] [PubMed] [Google Scholar]
  28. Zahn E. M., Houde C., Benson L., Freedom R. M. Percutaneous pericardial catheter drainage in childhood. Am J Cardiol. 1992 Sep 1;70(6):678–680. doi: 10.1016/0002-9149(92)90212-h. [DOI] [PubMed] [Google Scholar]

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