Cardiac tamponade in the emergency department: diagnostic and therapeutic utility of point-of-care ultrasound

• Cardiac tamponade is a life-threatening emergency that requires swift intervention • Diagnosis of cardiac tamponade may be challenging due to nonspecific symptoms • Point-of-care ultrasound provides rapid diagnostic and therapeutic capabilities • Point-of-care ultrasound aids real-time drainage of pericardial fluid • POCUS is a critical tool for the timely diagnosis and management of cardiac tamponade Cardiac tamponade is a life-threatening emergency caused by fluid accumulation in the pericardial sac, leading to reduced cardiac output. Early recognition and intervention are essential but can be challenging due to nonspecific symptoms and limited diagnostic resources, especially in low-resource settings. Point-of-care ultrasound (POCUS) is increasingly recognized for its rapid bedside diagnostic and therapeutic capabilities in such scenarios. We report the case of a 53-year-old woman who presented to the emergency department with progressive dyspnea and hemodynamic instability. Clinical examination was inconclusive, but POCUS revealed a large pericardial effusion with right ventricular diastolic collapse and a plethoric inferior vena cava, confirming cardiac tamponade. Urgent ultrasound-guided pericardiocentesis via the subxiphoid approach led to immediate clinical improvement. A pericardial drain was inserted, and the patient was managed under cardiology care with a favorable outcome. This case underscores the vital role of POCUS in diagnosing cardiac tamponade, particularly when clinical findings and ECG are inconclusive. POCUS enabled real-time visualization of tamponade physiology and safely guided therapeutic pericardiocentesis. Its portability, accessibility, and diagnostic accuracy make it indispensable in emergency and resource-limited environments. POCUS is a critical tool for the timely diagnosis and management of cardiac tamponade. Its integration into routine emergency care, especially in low-resource settings, enhances diagnostic precision, supports life-saving interventions, and should be prioritized in medical training and healthcare policy.