GA and PPV can result in life-threatening hypotension (vasodilation, myocardial depression, or decreased venous return).
Pericardiocentesis under local anesthesia is preferred
Induction: Ketamine or Benzo w/ N2O, relaxation (pancuronium)
Anticipate the change from hypotension to hypertension following release of severe tamponade.
Chronic: fibrous scarring and adhesions that create a rigid shell around the heart
Acute: fibroelastic constriction.
S/S: Increased CVP and low CO due to lack of diastolic filling of the heart. Signs often mimic RV failure w/o pulmonary congestion. AFib is a common manifestation. Kussmaul's sign is common however pulses paradoxus is not.
ECG: nonspecific, minor changes.
Constrictive Pericarditis Anesthesia
Minimze changes in HR, SVR, venous return, and contractility
Maintenance: Combo of opioids bentos, and N2O with or w/o volatiles.
Pericardial and Cardiac Trauma
Blood from aortic or cardiac injury can fill the pericardial space and cause cardiac tamponade