Key messages

• Early recognition and treatment of acute tamponade, before cardiogenic shock and cardiac arrest occur, is crucial.

• Volume loading and, if necessary, vasoactive agents may be necessary to maintain blood pressure and flow while preparing for drainage.

• The pericardial collection may be drained by needle pericardiocentesis or surgically via a subxiphoid pericardial window.

• After the life-threatening situation has been resolved by drainage, the cause should be sought and corrected where possible, for example antibiotics for a bacterial etiology or surgical repair of a myocardial laceration.

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