Cardiac Tamponade

Definition

Definition of Cardiac Tamponade
Cardiac tamponade, also known as pericardial tamponade, is an acute type of pericardial effusion in which fluid accumulates in the pericardium (the sac in which the heart is enclosed).

Cardiac tamponade is pressure on the heart muscle which occurs when the pericardial space fills up with fluid faster than the pericardial sac can stretch. If the amount of fluid increases slowly (such as in hypothyroidism) the pericardial sac can expand to contain a liter or more of fluid prior to tamponade occurring. If the fluid occurs rapidly (as may occur after trauma or myocardial rupture) as little as 100 ml can cause tamponade.

Symptoms

Symptoms of Cardiac Tamponade

1. Anxiety, restlessness
2. Chest pain
3. Radiating to the neck, shoulder, back, or abdomen
4. Sharp, stabbing
5. Worsened by deep breathing or coughing
6. Difficulty breathing
7. Discomfort, sometimes relieved by sitting upright or leaning forward
8. Fainting, light-headedness
9. Pale, gray, or blue skin
10. Palpitations
11. Rapid breathing
12. Swelling of the abdomen or other areas

Causes

Causes of Cardiac Tamponade
In this condition, blood or fluid collects in the pericardium. This prevents the ventricles from expanding fully. The excess pressure from the fluid prevents the heart from functioning normally.

Cardiac tamponade can occur due to:

1. Dissecting aortic aneurysm (thoracic)
2. End-stage lung cancer
3. Heart attack (acute MI)
4. Heart surgery
5. Pericarditis caused by bacterial or viral infections
6. Wounds to the heart

Diagnosis

Diagnosis of Cardiac Tamponade
There are no specific laboratory tests that diagnose tamponade. Echocardiogram is typically used to help establish the diagnosis.

Treatment

Treatment of Cardiac Tamponade
Cardiac tamponade is an emergency condition that requires hospitalization. The fluid around the heart must be drained. Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac, the tissue that surrounds the heart.

A procedure to cut and remove part of the pericardium (surgical pericardiectomy or pericardial window) may also be done.

Fluids are given to maintain normal blood pressure until pericardiocentesis can be performed. Medications that increase blood pressure may also help sustain the patient's life until the fluid is drained.

The patient may be given oxygen. This reduces the workload on the heart by decreasing tissue demands for blood flow.

Prognosis

Prognosis of Cardiac Tamponade
Tamponade is life-threatening if untreated. The outcome is often good if the condition is treated promptly, but tamponade may come back.

Prevention

Prevention of Cardiac Tamponade
Many cases are not preventable. Awareness of your personal risk factors may allow early diagnosis and treatment.