Cardiac tamponade secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]; Hafiz M. Ahmed, M.D.[3]
Overview
Secondary prevention of cardiac tamponade focuses on preventing recurrent hemodynamic compromise after a pericardial effusion or tamponade episode. Strategies include treating the underlying cause, monitoring clinically significant effusions, using anti-inflammatory therapy when effusion is associated with active pericardial inflammation, and considering more durable drainage strategies in selected patients with recurrent large effusion or recurrent tamponade.
Secondary Prevention
- The underlying cause of pericardial effusion should be identified and treated when possible.
- Transthoracic echocardiography may be used for surveillance of pericardial effusions that are at least moderate in size.
- Inflammatory pericardial effusion without concern for tamponade should generally be treated with anti-inflammatory therapy before pericardiocentesis is considered.
- Pericardiocentesis is recommended for established or impending cardiac tamponade.
- Surgical creation of a pericardial window may be considered in selected patients with recurrent large pericardial effusion and/or recurrent cardiac tamponade despite prior pericardiocentesis.[1]
References
- ↑ Wang TKM, Klein AL, Cremer PC, Imazio M, Kohnstamm S, Luis SA, Mardigyan V, Mukherjee M, Ordovas K, Vakamudi S, Wohlford GF. 2025 Concise Clinical Guidance: An ACC Expert Consensus Statement on the Diagnosis and Management of Pericarditis: A Report of the American College of Cardiology Solution Set Oversight Committee. Journal of the American College of Cardiology. 2025;86(25):2691-2719. https://doi.org/10.1016/j.jacc.2025.05.023.