Patient handout

Cardiac tamponade

PRODUCTION

1. Your condition

This handout is for cardiac tamponade. Your care team identified this based on: dyspnea + hypotension + jvd (beck triad; spodick circulation 2003).

Other reasons your team may use this plan: echo: pericardial effusion + rv diastolic collapse / ivc plethora (esc 2015 §tamponade diagnosis); pulsus paradoxus >10 mmhg (roy jama 2007; spodick circulation 2003); recent pericarditis / malignancy / post-cardiac surgery / trauma (ristić ehj 2014).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
normal saline	500–1000 mL bolus	IV	rapid bolus then reassess	Increase preload to overcome pericardial restriction; reassess after 500 mL (ESC 2015 §Tamponade Management; Spodick Circulation 2003)
norepinephrine	0.05–0.1 µg/kg/min	IV	continuous; titrate to MAP ≥65	Bridge only — does not address obstruction (Roy JAMA 2007)
dobutamine	2.5 µg/kg/min	IV	continuous	For post-drainage low-output state (ESC 2015 §Post-Drainage Management)

Plan: Tamponade — pericardiocentesis-first with bridge therapy (ESC 2015 Class I)

3. When to call your provider

Contact your care team if any of the following happen:

Recurrence despite optimal therapy → transfer ownership to cardio.pericarditis.core.v1 + IL-1 escalation evaluation (AIRTRIP/RHAPSODY)
New hemodynamic compromise → ED for emergent re-evaluation (ESC 2015 Class I — repeat tamponade pathway)
Effusive-constrictive pattern persisting >3 mo → CMR + cardiothoracic referral for pericardiectomy evaluation (ESC 2015 Class IIa; Sagristà-Sauleda PMID 14749455)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

SBP <90 + Beck triad + echo confirms tamponade physiology (Spodick Circulation 2003; ESC 2015)(life-threatening)
Tamponade from Type A dissection / post-PCI/ablation / trauma / AC + post-procedure (ESC 2015 §Iatrogenic Tamponade)(life-threatening)
Tamponade in known/new cancer with malignant cells on cytology (Ristić EHJ 2014)
Re-accumulation within 7 days of initial drainage (ESC 2015 §Recurrent Pericardial Effusion)
Tamponade in ESRD / advanced CKD (ESC 2015 §Uremic Pericarditis)

6. Sources

Guideline: 2015 ESC Guidelines for the diagnosis and management of pericardial diseases (Adler Y et al, Eur Heart J 2015;36:2921-64, PMID 26320112) — remains current as of 2026-05-14; ESC 2026 update not yet announced. ICAP / CORP / CORP-2 / AIRTRIP / RHAPSODY anchor post-drainage anti-inflammatory + IL-1 escalation evidence base. Roy JAMA 2007 Rational Clinical Examination chapter (PMID 17456823) anchors physical exam likelihood ratios.