We describe three patients with cardiac tamponade who had been admitted to a coronary care unit, two because of rupture of the free wall during acute myocardial infarction and one because of proximal aortic dissection. Pericardiocentesis was performed in the coronary care unit after the diagnosis had been made by echocardiography. One of the patients with acute infarction and the one with proximal aortic dissection, who also underwent surgery, survived. We discuss various aspects of acute cardiac tamponade with hemopericardium.