The condition cardiac tamponade occurs when fluid accumulates in the sac surrounding the heart, known as the pericardium, causing the heart to not pump blood properly. In order to treat cardiac tamponade effectively, medical attention is required immediately.
Cardiac tamponade can be caused by various factors that lead to fluid buildup in the pericardium. Some of the common causes are:
Trauma or injury to the chest, such as from a car accident, a stab wound, or a gunshot.
Heart attack or rupture of the heart muscle, which can cause bleeding into the pericardium.
Inflammation or infection of the pericardium, which can cause fluid or pus to collect in the pericardial space. This condition is called pericarditis and can be caused by viruses, bacteria, fungi, or autoimmune diseases.
Aortic dissection or rupture, which is a tear in the wall of the aorta, the main artery that carries blood from the heart to the rest of the body. This can cause blood to leak into the pericardium.
Cancer that spreads to the pericardium or originates from the pericardium, such as mesothelioma or lymphoma.
Kidney failure or hypothyroidism, which can cause fluid retention and edema in the body, including the pericardium.
Certain medications or procedures that affect the pericardium, such as anticoagulants, chemotherapy, radiation therapy, or cardiac surgery.
Fluid accumulation in the pericardium can cause cardiac tamponade to cause severe and sudden symptoms. If the fluid builds up slowly, the symptoms can be mild. Some of the common symptoms include:
Chest pain or pressure, which may radiate to the neck, shoulder, back, or arm. The pain may worsen with deep breathing, coughing, or lying down.
Shortness of breath or difficulty breathing, which may be accompanied by rapid or shallow breathing.
Dizziness, fainting, or lightheadedness, which may be caused by low blood pressure and reduced blood flow to the brain.
Palpitations, which are sensations of a fast, irregular, or pounding heartbeat.
Swelling or bulging of the veins in the neck, which are caused by increased pressure in the veins that return blood to the heart.
Bluish or pale skin color, which is caused by low oxygen levels in the blood.
Anxiety, confusion, or restlessness, which may be caused by reduced blood flow to the brain and other organs.
A cardiac tamponade is diagnosed based on the medical history, physical examination, and various tests that confirm the presence and severity of fluid in the pericardium. These tests include:
An electrocardiogram (ECG) records the electrical activity of the heart. Cardiac tamponade can cause the ECG pattern to change, such as low voltage, electrical alternans, or ST segment elevation.
Cardiac tamponade can cause enlargement of the heart and pericardium, which can be seen on an X-ray.
Heart tamponade can cause collapse of the heart chambers, reduced filling of the heart, and abnormal movement of the pericardium. An echocardiogram is a test that uses sound waves to create images of the heart and its structures.
In cardiac catheterization, a thin tube is inserted into a blood vessel and advanced to the heart to measure heart pressure caused by cardiac tamponade.
During pericardiocentesis, a needle is inserted into the pericardium and fluid is drained. This procedure can relieve pressure on the heart as well as provide a sample of the fluid.
The treatment of cardiac tamponade aims to remove the excess fluid from the pericardium and treat the underlying cause of the fluid accumulation. The treatment options include:
A pericardiocentesis is the first-line treatment for cardiac tamponade. This procedure reduces the pressure on the heart and improves symptoms, but does not prevent the recurrence of fluid buildup, especially if the cause is not addressed.
In the pericardial window surgery, a small opening is created in the pericardium to allow fluid to drain into the chest. As well as preventing the recurrence of fluid buildup, this procedure can be used to examine the pericardium for signs of infection or cancer.
This procedure involves removing part or all of the pericardium in order to prevent fluid buildup and to treat conditions that affect the pericardium, such as inflammation, infection, or cancer.
Antibiotics, anti-inflammatory drugs, or diuretics can be used to treat the underlying cause of fluid accumulation, such as infections, inflammation, or fluid retention. Heart function can also be supported with medications, such as vasopressors for low blood pressure, inotropes for low cardiac output, or antiarrhythmics for irregular heartbeats.
The prevention of cardiac tamponade depends on the prevention of the underlying cause of the fluid accumulation. Some of the general measures that can help prevent cardiac tamponade are:
Avoiding or treating chest trauma or injury, such as wearing a seat belt, avoiding violent activities, or seeking medical attention for chest wounds.
Managing or preventing heart conditions, such as controlling blood pressure, cholesterol, and blood sugar levels, quitting smoking, exercising regularly, eating a healthy diet, or taking medications as prescribed.
Treating or preventing infections, such as getting vaccinated, washing hands frequently, avoiding contact with sick people, or taking antibiotics as prescribed.
Monitoring or treating other medical conditions, such as checking thyroid function, kidney function, or blood clotting factors, or taking medications as prescribed.
Following up with regular check-ups and tests, such as ECG, chest X-ray, or echocardiogram, especially if there is a history of pericarditis, pericardial effusion, or cardiac tamponade.
A cardiac tamponade occurs when fluid accumulates around the heart, causing a life-threatening condition called cardiac tamponade. In order to pump blood effectively, this fluid puts pressure on the heart. Several treatment options are available for cardiac tamponade, including pericardiocentesis, pericardial windows, pericardiectomy, or medications. By preventing the underlying cause of fluid accumulation, cardiac tamponade can be prevented. In general, preventing cardiac tamponade can be done by avoiding or treating chest trauma, managing or preventing heart conditions, treating or preventing infections, monitoring or treating other medical conditions, or following up with regular check-ups and tests.
