there is the introduction part of the torso trauma, check out my next ppts for further more about torso trauma. contents are in following order... introduction mechanism of injury junctional zones of torso tension pneumothorax cardiac temponade massive hemothorax etc. check out all slides

1. Pericardial tamponade
Presented by-Bhukesh
Paikra
Roll no-26
Department of Surgery

2. Content
• Introduction
• Pericardial effusion
• Cardiac tamponade
• Symptoms
• Diagnosis
• Lab investigation
• Treatment

3. Introduction

4. Pericardial effusion
• An abnormal accumulation of fluid inside the pericardial cavity
• Which can developed into cardiac temponade.
• Depending on the - how much fluid their is and how quick it
accumulates
• Rapid accumulation occurs due to -trauma
• Stabbing and blunt trauma
• Myocardial infarction
• Heart surgery
• Causes that take a long -cancers( often from lung or breast,uremic
pericarditis,hypothyroidism ,chronic inflammation

5. Cardiac tamponade
• So the temponade means fluids puts pressure on heart it self.
• In case of cardiac temponade the heart does not stretch out fully b/w
contractions
|
• Chambers don’t fill properly |
• Less cardiac output
|
• Hypotension
|
• Less blood supply to the organ.
• A decrease in the systolic BP of more then 10mmhg is called PULSUS
PARADOXUS.

6. Symptoms
• Beck’s triad -
• Distended jugular veins
• Hypotension
• Distant heart sound
• Other symptoms -
• Tachycardia
• Coughing
• Dyspnea
• Weakness
• Lightheadedness
• If severe the heart can become ischemic-low on blood may stops beating

7. Diagnosis
• CHEST X-RAY - cardiomegaly,bottle shap heart,chest wall trauma
• ECG- findings
• PR segment depression
• Low QRS complex voltage
• Electrical alternans
• ECHOCARDIOGRAPHY:- show
• Excess fluid
• Swinging heart inside the pericardial cavity
• CARDIAC CATHETERIZATION- measures pressure inside the
chamber
• In case of cardiac temponade pressure in all 4 chambers are equal

8. Lab Investigations
• Creatinine kinase and isoenzymes:- elevated in MI & cardiac trauma
• Renal profile -uremia if uremic pericarditis
• Antinuclear antibody assay and ESR-connective tissue disorder
• HIV testing- 24% pleural effusion is associated with HIV

9. Treatments
• Pericardiocentesis- needle is inserted inside the pericardium to
drainage excess fluid
• Supplemental oxygen
• Manage the underlying causes
• Volume expansion with blood plasma ,isotonic normal saline to
maintain adequate intravascular volume
• Bed rest with leg elevation (increase venous return)