Q. What Treatment should be used for cardiac tamponade?
Percutaneous Pericardiocentesis
Cardiac tamponade is an acute emergency and percutaneous pericardiocentesis must be done as immediately as possible. Ideally this should be done under 2DE guidance with haemodynamic monitoring. The percutaneous pericardiocentesis can be done from the subxiphoid region with needle directed towards the 2nd left costochondral junction. Fluid should be removed slowly. Removal of even small quantity of fluid can relieve the tamponade. Complications are damage to coronary arteries and laceration to heart and lungs.
See also under cardiac emergencies.
Surgical Pericardial Drainage
Surgical drainage of the pericardial fluid is considered in recurrent pericardial effusion. Surgical drainage gives an opportunity for pericardial biopsy which can confirm the etiology of PE. Pericardial window can be created for drainage of PE to left pleural cavity. This is done for recurrent large PE.
Specific Treatment
Depending upon the etiology of PE, specific treatment must be given.