Cardiac Tamponade

The incidence of cardiac tamponade following cardiothoracic surgery can reach 6% and can be a life-threatening emergency. The diagnosis of cardiac tamponade in the postoperative setting can be challenging for several reasons, which include the variety of etiologies of shock after cardiac surgery, that the historical clinical signs are seldom seen, and because investigative aids, such as echocardiography, have their limitations. A high index of suspicion of cardiac tamponade is therefore always warranted when assessing a deteriorating patient following cardiac surgery along with an up-to-date knowledge of cardiac arrest after cardiac surgery management. Surgical decompression of the mediastinum by emergency resternotomy is required for 20%–50% of cardiac arrests after cardiac surgery and may need to take place in the critical care environment, so awareness of and training in this procedure are imperative.