What are the indications for urgent referral to cardiology in cases of suspected cardiac tamponade?

Indications for urgent referral to cardiology in suspected cardiac tamponade include clinical features suggestive of cardiac tamponade such as rapid onset or worsening breathlessness, hypotension, elevated jugular venous pressure, muffled heart sounds, and signs of hemodynamic instability. Urgent admission or referral is warranted because cardiac tamponade is a life-threatening emergency requiring immediate specialist assessment and intervention.

Specifically, the NICE CKS guideline on breathlessness advises arranging emergency admission for people with clinical features of cardiac tamponade, recognizing it as a critical cause of breathlessness requiring urgent hospital care and cardiology input.

Therefore, any suspicion of cardiac tamponade based on clinical presentation mandates urgent referral to cardiology for assessment and management.

This is consistent with the general principle that suspected life-threatening cardiac conditions, including cardiac tamponade, require emergency admission and specialist cardiology assessment.

In summary:

• Suspected cardiac tamponade with clinical signs of hemodynamic compromise or severe breathlessness requires urgent cardiology referral and emergency admission.
• Urgent referral is indicated to enable prompt diagnosis (e.g., echocardiography) and treatment (e.g., pericardiocentesis).

This approach aligns with the guidance to arrange emergency admission for cardiac tamponade as a cause of breathlessness and cardiovascular compromise ².