Cardiac Tamponade

Cardiac Tamponade
(Tamponade, Pericardial Tamponade)

Definition
Cardiac tamponade occurs when the heart becomes compressed because of a surrounding accumulation of blood or fluid. The fluid accumulates between the heart muscle and the pericardium, the tissue that surrounds the heart muscle.
Because fluid fills the sac surrounding the heart, it becomes unable to expand properly and allow a sufficient amount of blood to be pumped in and out of the heart.
Cardiac tamponade is a very serious condition that can be life-threatening if untreated. However, if quickly diagnosed and treated, prognosis is good. Cardiac tamponade can recur after treatment.
Causes
Cardiac tamponade can be caused by a variety of factors and conditions, including:
• Pericarditis (an inflammation of the sac that surrounds the heart) caused by bacterial or viral infections
• Bleeding into the pericardium, caused by injury
• Ruptured heart muscle
• Cancer in or near the heart
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. The following conditions and other factors increase your chance of developing cardiac tamponade:
• Heart surgery
• Tumors in the heart
• Heart attack
• Injury to the heart
• End-stage lung cancer
• Kidney failure
• Radiation therapy to the chest
• Hypothyroidism
• Systemic lupus erythematosus
Symptoms
Symptoms of cardiac tamponade may vary from mild to severe and typically include one or more of the following:
• Fatigue or drowsiness
• Shortness of breath, rapid breathing, or difficulty breathing
• Dizziness or light-headedness
• Chest pain
o That extends to the neck, shoulders, or abdomen
o Sharp or stabbing pain
o Pain that is worsened by coughing or deep breathing
• Discomfort that can be relieved by sitting upright or leaning forward
• Swelling of the abdomen, veins in the arms or legs, or other areas
• Pale skin, or skin that is blue- or gray-tinted
• Rapid heartbeat
• Anxiety or restlessness
• Low blood pressure
• Fainting
• Feeling of weakness
• General malaise
Diagnosis
Your doctor will ask about your symptoms and medical history, and perform a physical exam. One of the criteria for diagnosing cardiac tamponade is a significant change in blood pressure between breaths.
Your doctor may also conduct one of the following tests to diagnose cardiac tamponade:
• Echocardiogram —a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart. This is the primary test used to diagnose and manage cardiac tamponade.
• Cardiac Catheterization —a tube-like instrument inserted into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply
• Chest X-ray —a test that uses radiation to take a picture of structures inside the body, especially bones
• CT Scan —a type of x-ray that uses a computer to make pictures of structures inside the chest
• MRI Scan —a test that uses magnetic waves to make pictures of structures inside the chest
• Coronary Angiography —x-rays taken after a dye is injected into the arteries; allows the doctor to look for abnormalities in the arteries
• Electrocardiogram (ECG, EKG) —a test that records the heart’s activity by measuring electrical currents through the heart muscle
Treatment
Cardiac tamponade is a serious, potentially life-threatening condition that requires immediate hospitalization and treatment.
Treatments are administered to:
• Save the patient's life
• Improve heart function
• Relieve symptoms
Treatments that are administered for cardiac tamponade include:
• Pericardiocentesis —a procedure to drain the fluid around the heart
• Fluids to maintain normal blood pressure
• Medications, including antibiotics
• Medications to help increase blood pressure to normal levels
• Oxygen to reduce workload on the heart
• Surgically removing or cutting part of the pericardium
Prevention
Most of the time, cardiac tamponade is not a preventable condition. However, understanding the risk factors for the condition can aid in prevention.