Once the diagnosis of cardiac tamponade is established, a focused assessment of concurrent conditions by an appropriately trained echocardiographer is indicated as long as it does not delay clinical stabilization and definitive management. The RV and LV should be assessed for size and systolic function. A distended RV with or without worsening tricuspid regurgitation raises concern for outflow obstruction or systolic dysfunction. Regional wall motion abnormalities might be apparent if there is active myocardial ischemia. The mitral valve prosthesis should be evaluated for malfunction using color flow Doppler, which might reveal stenosis or intravalvular regurgitation from leaflet dysfunction or paravalvular leak from suture line dehiscence.

References

• Carmona P, Mateo E, Casanovas I, et al. Management of cardiac tamponade after cardiac surgery. J Cardiothorac Vasc Anesth. 2012;26:302-311.
• Labovitz AJ, Noble VE, Bierig M, et al. Focused cardiac ultrasound in the emergent setting: a consensus statement of the American Society of Echocardiography and American College of Emergency Physicians. J Am Soc Echocardiogr. 2010;23:1225-1230.