Cardiac Tamponade

Illustration of cardiac tamponade showing the heart compressed by blood in the pericardial sac

This illustration shows cardiac tamponade, a condition where the pericardium becomes filled with blood (hemopericardium), compressing the heart and impairing its function.

Image by BruceBlaus, licensed under CC BY 3.0. Cited from: Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine, 1(2). DOI: 10.15347/wjm/2014.010. ISSN 2002-4436.

Definition

Cardiac tamponade is a medical condition in which fluid accumulates in the pericardial space surrounding the heart. This is a medical emergency because the heart is experiencing increased pressure as a result of build or build. Without treatment, cardiac tamponade can be fatal.

Aetiology

Acute causes: 

  • Chest trauma/injury

  • Idiopathic (no known causes)

  • Myocardial infarction (MI) 

  • Pericarditis

  • Heart surgery generally caused by a  post-surgical complications

Chronic causes:

  • Cancer.

  • CKD related uremia

  • Connective tissue disorders such as rheumatoid arthritis (RA) and Lupus. 

  • Tuberculosis (TB): a complication from TB. 

Pathophysiology

The accumulation of fluid in the pericardial space raises the heart's intracardiac pressure, impairing its ability to pump blood. Additionally, there is a decrease in blood flow through the heart.

Risk factors

  • Pericarditis: Individuals with a history of previous pericarditis (inflammation of the pericardium)

  • Cancer

  • Heart failure

  • Kidney failure

  • Radiation therapy: radiation therapy performed around the heart area

Sign and symptoms

  • Shortness of breath 

  • Chest pain

  • Tachycardia 

  • Tachypnoea

  • Weakness 

  • Dizziness

Investigations

Diagnosis starts with a physical examination of the patient and a good history.

Investigations may include: 

  • ECG 

  • CXR - fluid in the pericardial space can be observed 

  • ECHO 

  • CT SCAN 

  • MRI 

  • Cardiac catheterisation

  • Culture of fluid from a pericardiocentesis

Management

  • Medical emergency - patient must be admitted to the hospital 

  • Pericardiocentesis: drainage of fluid in the pericardial space through a needle or a catheter inserted through the chest into the pericardial space. 

  • Treat underlying causes such as TB, pericarditis, MI etc.

 
CardiologymypanotesCardiac Tamponade