Cardiac Tamponade

1. Illness Script for Tamponade:
Think tamponade when you see a predisposed (mediastinal procedure, hypothyroidism, infection, malignancy, preceding viral prodrome) patient present with acute dyspnea with evidence of elevated right sided pressures with tachycardia/hypotension who is found to have supporting objective evidence (pulsus paradoxus >10mmHg, bedside US with effusion, CXR with enlarged cardiac silhouette, findings on echocardiogram).

2. Cardiac Tamponade and Cancer:
By and large this is the most common cause of hemorrhagic effusion with tamponade. It carries a poor prognosis, with only 20% of patients surviving beyond 6 months from diagnosis.

3. Exam for Tamponade:
Please see the linked Rational Clinical Exam article for further reading on the physical exam of cardiac tamponade.