Respiratory Distress

doi:10.1017/9781009500760.019

Chapter 19 - Respiratory Distress

Published online by Cambridge University Press: 24 April 2026

Amir Louka and

Kristen Piwowarski

Edited by

Angela Bray Lindsay and

Monica Kathleen Wattana

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Angela Bray Lindsay: Affiliation:
Virginia Commonwealth University
Monica Kathleen Wattana: Affiliation:
University of Texas, MD Anderson Cancer Center

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Summary

1. The diagnosis of cancer-related pericardial effusion is usually incidental, but cancer accounts for approximately one third of all cardiac tamponades.

2. IV fluids may assist in expanding the right ventricle to avoid compression in tamponade.

3. Beck’s triad includes hypotension, jugular venous distention (JVD), and muffled heart sounds. However, shortness of breath and chest pain are the most common presenting symptoms.

4. Echocardiogram is the gold standard for diagnosis of pericardial effusion. Assess for fluid collection, diastolic collapse beginning with the right atrium, and inferior vena cava (IVC) and/or hepatic vein flow.

5. Drainage, typically through pericardiocentesis, is needed when cancer or treatment-related pericardial effusion leads to hemodynamic compromise.

Keywords

Cardiac tamponade malignant pericardial effusion cancer shortness of breath pericardiocentesis echocardiography oncologic emergency pulsus paradoxus shock hemodynamic compromise

Information

Type: Chapter
Information: Oncologic Emergency Medicine
Clinical Cases Illustrating Key Concepts
, pp. 92 - 96

DOI: https://doi.org/10.1017/9781009500760.019 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2026

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