Cardiac Tamponade

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Echocardiographic Assessment

• Look for right atrial systolic collapse (duration > 1/3 of systole)
• Look for Right ventricular diastolic collapse
• Look for paradoxical septal motion
• Check for IVC Plethora and >50% reduction with inspiration
• Assess amount of fluid which will be anterior to the descending aorta
  • <1 cm small
  • 1-2cm moderate
  • >2cm large
• Measure pulse wave doppler across mitral valve
  • Inspiration decrease >25%
  • Expiration increase >25%
• Measure pulse wave Doppler across tricuspid valve
  • Increase with inspiration
  • Decrease with expiration
• Measure pulmonary vein and hepatic vein flows which will be blunted or reversed
• Check deceleration times which will decrease with constriction not tamponade