What is the treatment for massive hemopericardium and cardiac tamponade?

Massive hemopericardium and cardiac tamponade constitute a life-threatening condition requiring immediate pericardiocentesis. Depending on the etiology and potential for ongoing bleeding, the pericardial effusion can be drained with either a needle or percutaneous catheter drainage under echocardiographic guidance. When performed at the bedside for life-saving purposes, the subxyphoid approach is considered the safest. Surgical drainage may be necessary if the pericardial effusion cannot be completely evacuated by percutaneous drainage. If ongoing bleeding is anticipated or if there is suspicion of an intrapericardial source of bleeding (eg, myocardial rupture, great vessel injury, penetrating injury, aortic dissection, iatrogenic injury during intracardiac procedures), emergency surgical intervention is required.