Épanchement péricardique et tamponnade : du mécanisme à la prise en charge thérapeutique

Pericardium is a double layer surrounding the heart and responsible for ventricular coupling. A pericardial effusion, above a certain amount, increases intrapericardial pressure, increases ventricular coupling and decreases venous return. The diagnosis of tamponade is clinical and also based on echocardiography. Direct visualization of right cavities collapse with increased respiratory variations of inflow and output flow is of utmost importance for tamponade diagnosis. Pericardiocentesis and sustaining adequate perfusion pressure are the key of the treatment. In some clinical settings, drainage has to be surgical.