Pericardial tamponade. Theoretical considerations and technical aspects of pericardiocentesis

The diagnosis of pericaridal tamponade is inferred by clinical examination, supported by echocardiography, and established by hemodynamic monitoring. Once the diagnosis is confirmed, prompt drainage of the fluid by pericardiocentesis or surgical intervention is mandatory. The choice between the two depends upon the clincal status of the patient, available facilities and personnel, and the experience of the physician involved with the procedure. In appropriately selected cases, pericardiocentesis, directed by two-dimensional echocardiography, is simple and safe. This chapter reviews the approaches to the diagnosis of pericardial tamponade with an emphasis on the role of echocardiography in planning and performing a successful pericardiocentesis.