Diagnosis and management of cardiac tamponade and pericardial effusion

Objective To review the experience of diagnosis and management of cardiac tamponade and pericardial effusion. Methods Thirty-six patients with cardiac tamponade were treated from Jan. 1998 to Jan. 2003 in our department. They were male in 25 and female in 11. The diagnosis was confirmed in all patients by echocardiography. Pericardiocentesis was preformed in 21 cases and subxiphoid surgical pericardiectomy was preformed in 15 cases. If the cause of the pericardial effusion is uncertain, 100 to 200 ml of fluid was collected for diagnostic studies, including cell count and differentiation, protein, lactate dehydrogenase, glucose, gram stain, and bacterial cultures, fungal cultures, myocobacterial acid fast stain, and culture. ResultsSymptoms of cardiac tamponade and pericardial effusion were relieved after pericardiocentesis or subxiphoid surgical pericardectomy in all patients. Thirty-four patients survived, 1 patient died of acute hepatic and renal failure and 1 patient died of low cardiac output with a mortality of 5.5% (2/36). Conclusion Identify early cardiac tamponade and intervene appropriately are very important. Along with a complete physical assessment, echocardiography remains the fastest and most accurate way to diagnose cardiac tamponade. Pericardiocentesis and subxiphoid surgical pericardiectomy are simple, safe, and effective for primary treatment of cardiac tamponade and pericardial effusion.