Cardiac tamponade
A case by Dr Ray Mohan
This was a case I recently had of a patient that came in short of breath and hypotensive. A quick subcostal view on a bedside echo demonstrated all the necessary information .
A large circumferential effusion causing diastolic right atrial and ventricular collapse.
We took the patient emergently to the OR and preformed a pericardial window. Pericardiocentesis can be performed as an emergency measure while the pericadial window is made.
Immediately on penetration of the pericardium, a bloody fluid was released and hypotension resolved instantaneously!
The surgeon gave me a great piece of information when the fluid came out...he asked how do you know that this bloody fluid isn’t from a dissection or rupture?
Answer: it doesn’t clot! The fluid from the pericardium, though bloody appearing, doesn’t have clotting factors if it’s not from the active circulation. Having a good surgeon in your cardiology program is #Priceless *
