injuries poisoning
Cardiac Tamponade
Key Points
Cardiac tamponade is most often caused by a penetrating wound medial to the nipples (for anterior wounds) or the scapulae (for posterior wounds). The triad of muffled heart tones, hypotension, and neck vein distention is diagnostic but not always present; in their absence, bedside echocardiography should be done if the diagnosis is suspected. Subxiphoid pericardiocentesis is a temporizing measure and may be falsely negative; a pericardial window or pericardiotomy is more definitive. 