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→Treatment
===Treatment===
===Treatment===
====Pericardiocentesis====
====Pericardiocentesis====
Pericardiocentesis is a useful diagnostic test as well as treatment. This is the only effective treatment for cardiac tamponade. Diuretics should '''not''' be given prior to pericardiocentesis, as they will reduce circulating fluid volume and therefore preload. This will further decrease cardiac pressures, cardiac output and exacerbate tamponade. It is advisable to have continuous ECG monitoring throughout the procedure, as any contact with the myocardium may result in arrhythmias.
The effusion frequently has a haemorrhagic appearance, regardless of underlying aetiology. It is possible to inadvertently sample blood from the right ventricle during attempted pericardiocentesis. The effusion sample can be differentiated from right ventricular blood by the fact it does not clot.
The effusion frequently has a haemorrhagic appearance, regardless of underlying aetiology. It is possible to inadvertently sample blood from the right ventricle during attempted pericardiocentesis. The effusion sample can be differentiated from right ventricular blood by the fact it does not clot.
Risks of the procedure include:
Risks of the procedure include:
* Haemorrhage
* Ventricular arrhythmias
* Accidental puncture of the right ventricle and removal of right ventricular blood, resulting in hypovolaemic shock
* Coronary laceration (reduce risk by using the right side for pericardiocentesis)
* Tumour laceration
* Infection
====Surgery====
====Surgery====
The most common surgical treatment is '''subtotal pericardectomy'''.
The most common surgical treatment is '''subtotal pericardectomy'''.
===Prognosis===
===Prognosis===