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JOURNAL ARTICLE

Point-of-Care Diagnosis of Cardiac Tamponade Identified by the Flow Velocity Paradoxus

William Shyy, Roneesha S Knight, Aaron Kornblith, Nathan A Teismann
Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine 2017, 36 (11): 2197-2201
28503752
The presentation of cardiac tamponade is a spectrum from occult to extreme. The clinical history, physical exam, electrocardiogram, and radiographic findings of tamponade have poor sensitivities and even worse specificities. We use a clinical scenario to demonstrate how point-of-care cardiac ultrasound can diagnose impending cardiac tamponade in a clinically stable patient. The ultrasound finding we recommend is the flow velocity paradoxus, in which respiratory variation causes significant changes in transvalvular inflow velocities, which are exaggerated when tamponade is present. The management of a pericardial effusion depends on its physiologic effect, and point-of-care ultrasound directly measures that effect and expedites patient care.

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