Cardiac Tamponade

Key points

• Features: dyspnoea · tachycardia · hypotension · muffled heart sounds · pulsus paradoxus
• Raised JVP with an absent Y descent (limited right ventricular filling) · Kussmaul's sign (much debated) · ECG: electrical alternans
• vs constrictive pericarditis: tamponade JVP absent Y descent (constriction X + Y present) · pulsus paradoxus present (absent in constriction)
• Kussmaul's sign rare in tamponade, present in constriction · pericardial calcification on CXR is characteristic of constrictive pericarditis
• Mnemonic: TAMponade = TAMpaX (absent Y descent)