Cardiac tamponade

Etiology / Pathophysiology

• Fluid or blood accumulates in the pericardial sac after trauma, procedure, malignancy, infection, or pericardial disease.
• Rising pericardial pressure prevents ventricular filling, reducing stroke volume and cardiac output.

Medications

No specific medication class was seeded for this card.

Signs / symptoms

• Dyspnea or tachypnea.
• Sharp chest pain that may radiate to the neck, shoulder, back, or abdomen.
• Tachycardia or palpitations.
• Anxiety, restlessness, lightheadedness, or syncope.
• Pale, gray, or cyanotic skin with weak pulses.
• Hypotension with jugular venous distention and muffled heart sounds.

Nursing actions

• Assess airway, breathing, circulation, blood pressure trend, heart sounds, JVD, pulse pressure, and mental status.
• Keep the client on oxygen, maintain IV access, and notify the provider or rapid response for suspected tamponade.
• Prepare for echocardiogram and emergency pericardiocentesis or surgical intervention as ordered.

Complications

• Obstructive shock
• PEA arrest
• Organ hypoperfusion
• Death

NCLEX cues

• Hypotension plus JVD and muffled heart sounds.
• Narrowing pulse pressure.
• Restlessness after chest trauma or cardiac procedure.

Memory hooks

• Tamponade squeezes the heart from the outside.

Labs / Diagnostics

• Echocardiogram
• ECG changes
• Chest imaging
• Blood pressure and pulse pressure trends

Review notes

• Supplemental wife-requested study card. Use for NCLEX review only and verify against school materials, ATI/NCLEX review sources, current orders, and facility policy.