Point-of-Care Ultrasound in Early Identification of Tamponade: A Case Series

Cardiac tamponade is a life-threatening condition resulting from fluid accumulation within the pericardial sac, leading to impaired cardiac filling and output. Signs described in the literature, such as Beck's triad (hypotension, jugular venous distension (JVD), muffled heart sounds) or pulsus paradoxus can be absent especially in the early stages, particularly in non-trauma patients, making early diagnosis challenging. In this case series, we present three patients who developed tamponade with subtle symptoms, including shortness of breath and tachycardia, but without hypotension or other hallmark signs. Cardiac point-of-care ultrasound (POCUS) played a critical role in early detection, revealing pericardial effusion and right ventricular (RV) diastolic collapse. Rapid diagnosis facilitated timely pericardiocentesis, which resolved symptoms and prevented further decompensation. This series underscores the value of POCUS in detecting early-stage tamponade, where traditional clinical markers of hypotension, JVD, muffled heart sounds, and pulsus paradoxus may not be present. The main purpose of this article is to showcase how early use of cardiac POCUS can prompt cardiology consultation and appropriate management, improving patient outcomes.