Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Inadequate perfusion• Compression of the heart or great veins +++ Epidemiology + • Pericardial tamponade• Tension pneumothorax• Abdominal compartment syndrome• Diaphragmatic rupture with abdominal viscera in chest +++ Symptoms and Signs + • Distended neck veins• Postural hypotension• Oliguria• Sweating• Mental status changes• Kussmaul sign: Distention of neck veins with deep inspiration is pathognomonic of pericardial tamponade• Paradoxic pulse: A fall of > 10 mm Hg with inspiration supports diagnosis• Equalization of heart chamber pressures with pulmonary artery catheter placement + • Mechanism of injury often raises suspicion• Decision must sometimes be made for intervention without full confirmation of diagnosis, eg, thrombectomy or pericardial aspiration for penetrating chest injuries and loss of signs of life + • Physical exam/trauma work-up + • Fluid infusion can bring transient improvement• Definitive treatment must correct mechanical abnormality• See Thoracic Injuries and Abdominal Injuries• See Small Intestine, Obstruction. +++ Surgery +++ Indications + • See section on particular etiology +++ Treatment Monitoring + • Blood pressure• ECG +++ Prognosis + • Varies with etiology and severity +++ References ++American College of Surgeons: ATLS: Advanced Trauma Life Support Student Manual. American College of Surgeons, 2004. Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth