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It encompasses a heterogenous pathophysiology and is used to describe hemodynamic compromise secondary to a coronary artery perforation, without free\u2010flowing fluid in the pericardium. Tamponade physiology can result from compressive epicardial, intramyocardial, subepicardial hematomas, or dissecting intramyocardial hematomas. The diagnosis of dry tamponade requires hemodynamic derangement in the context of a compressive hematoma as demonstrated by imaging. Although echocardiography can often help identify dry tamponade, additional studies including right heart catheterization, computed tomography, or cardiac magnetic resonance imaging can inform the exact mechanism and help guide management. This article describes a case of dry tamponade, reviews the existing literature on the topic, and offers expert recommendations on diagnosis and management.<\/jats:p>","DOI":"10.1002\/ccd.31241","type":"journal-article","created":{"date-parts":[[2024,10,2]],"date-time":"2024-10-02T03:54:45Z","timestamp":1727841285000},"page":"1228-1240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Challenges in the diagnosis and management of dry tamponade"],"prefix":"10.1002","volume":"104","author":[{"given":"Jasleen","family":"Tiwana","sequence":"first","affiliation":[{"name":"Alaska Heart and Vascular Institute Anchorage Alaska USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen E.","family":"Kearney","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William L.","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"Azzalini","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.90.6.2725"},{"key":"e_1_2_11_3_1","first-page":"1902","article-title":"A detailed analysis of perforations during chronic total occlusion angioplasty","volume":"12","author":"Hirai T","year":"2019","journal-title":"Cardiovasc Interv"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-19-00282"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/14779072.2021.1850264"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2022.11.023"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.118.007338"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcr\/ytac316"},{"key":"e_1_2_11_9_1","first-page":"204","article-title":"Unusual presentation of late regional cardiac tamponade after aortic surgery","volume":"10","author":"Jadhav P","year":"1996","journal-title":"Am J Card Imaging"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(94)90561-4"},{"key":"e_1_2_11_11_1","first-page":"189","article-title":"ST\u2010elevation myocardial infarction caused by coronary artery compression due to localized pericardial hematoma caused by coronary perforation","volume":"22","author":"Cafri C","year":"2010","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2018.09.028"},{"key":"e_1_2_11_13_1","first-page":"1","article-title":"What is the cause of hypotension? 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