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Cardiac
Diagnosis
Pericardial
Pericardial Tamponade
Pericardial Tamponade
Darragh Brady, MD; John Duignan, MB BCh, BAO, MRCPI; Jonathan D. Dodd, MD, MSc, MRCPI, FFR(RCSI)
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Compression of heart chambers by pericardial fluid, gas, or solid tissue with hemodynamic sequelae
              • Potential space separates visceral and parietal serosal layers and normally contains up to 50 mL of serous fluid (plasma ultrafiltrate)
                • Pressure-volume curve behavior of this finite space depends on rate of accumulation
                • When intrapericardial pressure rises to critical point, lowest pressure chambers are compressed first, and hemodynamic sequelae are manifest

          IMAGING

          • General Features

            • Radiographic Findings

              • Fluoroscopic Findings

                • CT Findings

                  • MR Findings

                    • Echocardiographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            CLINICAL ISSUES

                            • Presentation

                              • Treatment

                                Selected References

                                1. Tuck BC et al: Clinical update in pericardial diseases. J Cardiothorac Vasc Anesth. ePub, 2018
                                2. Appleton C et al: Cardiac tamponade. Cardiol Clin. 35(4):525-37, 2017
                                3. Azarbal A et al: Pericardial effusion. Cardiol Clin. 35(4):515-24, 2017
                                4. Xu B et al: Imaging of the pericardium: A multimodality cardiovascular imaging update. Cardiol Clin. 35(4):491-503, 2017
                                5. Adler Y et al: 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 36(42):2921-64, 2015
                                6. Dawson D et al: Contemporary imaging of the pericardium. JACC Cardiovasc Imaging. 4(6):680-4, 2011. Erratum in: JACC Cardiovasc Imaging. 4(7):819, 2011
                                7. Rajiah P: Cardiac MRI: Part 2, pericardial diseases. AJR Am J Roentgenol. 197(4):W621-34, 2011
                                8. Fortuño Andrés JR et al: Radiological approach to cardiac tamponade. Radiologia. 52(5):414-24, 2010
                                9. Rajiah P et al: Computed tomography of the pericardium and pericardial disease. J Cardiovasc Comput Tomogr. 4(1):3-18, 2010
                                10. Yared K et al: Multimodality imaging of pericardial diseases. JACC Cardiovasc Imaging. 3(6):650-60, 2010
                                11. Klein SV et al: CT directed diagnostic and therapeutic pericardiocentesis: 8-year experience at a single institution. Emerg Radiol. 11(6):353-63, 2005
                                12. Weich HS et al: Large pericardial effusions due to systemic lupus erythematosus: a report of eight cases. Lupus. 14(6):450-7, 2005
                                13. Kabukcu M et al: Pericardial tamponade and large pericardial effusions: causal factors and efficacy of percutaneous catheter drainage in 50 patients. Tex Heart Inst J. 31(4):398-403, 2004
                                14. Spodick DH: Acute cardiac tamponade. N Engl J Med. 349(7):684-90, 2003
                                15. Goldstein L et al: CT diagnosis of acute pericardial tamponade after blunt chest trauma. AJR Am J Roentgenol. 152(4):739-41, 1989
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Top Differential Diagnoses

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Definitions

                                          • Compression of heart chambers by pericardial fluid, gas, or solid tissue with hemodynamic sequelae
                                            • Potential space separates visceral and parietal serosal layers and normally contains up to 50 mL of serous fluid (plasma ultrafiltrate)
                                              • Pressure-volume curve behavior of this finite space depends on rate of accumulation
                                              • When intrapericardial pressure rises to critical point, lowest pressure chambers are compressed first, and hemodynamic sequelae are manifest

                                        IMAGING

                                        • General Features

                                          • Radiographic Findings

                                            • Fluoroscopic Findings

                                              • CT Findings

                                                • MR Findings

                                                  • Echocardiographic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Treatment

                                                              Selected References

                                                              1. Tuck BC et al: Clinical update in pericardial diseases. J Cardiothorac Vasc Anesth. ePub, 2018
                                                              2. Appleton C et al: Cardiac tamponade. Cardiol Clin. 35(4):525-37, 2017
                                                              3. Azarbal A et al: Pericardial effusion. Cardiol Clin. 35(4):515-24, 2017
                                                              4. Xu B et al: Imaging of the pericardium: A multimodality cardiovascular imaging update. Cardiol Clin. 35(4):491-503, 2017
                                                              5. Adler Y et al: 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 36(42):2921-64, 2015
                                                              6. Dawson D et al: Contemporary imaging of the pericardium. JACC Cardiovasc Imaging. 4(6):680-4, 2011. Erratum in: JACC Cardiovasc Imaging. 4(7):819, 2011
                                                              7. Rajiah P: Cardiac MRI: Part 2, pericardial diseases. AJR Am J Roentgenol. 197(4):W621-34, 2011
                                                              8. Fortuño Andrés JR et al: Radiological approach to cardiac tamponade. Radiologia. 52(5):414-24, 2010
                                                              9. Rajiah P et al: Computed tomography of the pericardium and pericardial disease. J Cardiovasc Comput Tomogr. 4(1):3-18, 2010
                                                              10. Yared K et al: Multimodality imaging of pericardial diseases. JACC Cardiovasc Imaging. 3(6):650-60, 2010
                                                              11. Klein SV et al: CT directed diagnostic and therapeutic pericardiocentesis: 8-year experience at a single institution. Emerg Radiol. 11(6):353-63, 2005
                                                              12. Weich HS et al: Large pericardial effusions due to systemic lupus erythematosus: a report of eight cases. Lupus. 14(6):450-7, 2005
                                                              13. Kabukcu M et al: Pericardial tamponade and large pericardial effusions: causal factors and efficacy of percutaneous catheter drainage in 50 patients. Tex Heart Inst J. 31(4):398-403, 2004
                                                              14. Spodick DH: Acute cardiac tamponade. N Engl J Med. 349(7):684-90, 2003
                                                              15. Goldstein L et al: CT diagnosis of acute pericardial tamponade after blunt chest trauma. AJR Am J Roentgenol. 152(4):739-41, 1989