What should be the focus of history to identify the probable etiology of cardiac tamponade?

Updated: Nov 28, 2018
  • Author: Chakri Yarlagadda, MD, FACC, FSCAI, FASNC, CCDS; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

A comprehensive review of the patient's history usually helps in identifying the probable etiology of a pericardial effusion. The following may be noted:

  • Patients with systemic or malignant disease present with weight loss, fatigue, or anorexia

  • Chest pain may be the presenting symptom in patients with pericarditis or myocardial infarction

  • Musculoskeletal pain or fever may be present in patients with an underlying connective tissue disorder

  • A history of renal failure can lead to a consideration of uremia as the cause of pericardial effusion

  • Careful review of a patient's medications may indicate that drug-related lupus caused the pericardial effusion

  • Recent cardiovascular surgery, coronary intervention, or trauma can lead to the rapid accumulation of pericardial fluid and tamponade [5]

  • Recent pacemaker lead implantation or central venous catheter insertion can lead to the rapid accumulation of pericardial fluid and tamponade [13]

  • Consider HIV-related pericardial effusion and tamponade if the patient has a history of intravenous (IV) drug abuse or opportunistic infections

  • Inquire about chest wall radiation - Ie, for lung, mediastinal, or esophageal cancer

  • Inquire about symptoms of night sweats, fever, and weight loss, which may be indicative of tuberculosis


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