Cardiac tamponade is a life-threatening condition. If the symptoms of cardiac tamponade are not recognized in time, it will result in cardiac arrest and death. What are the causes of tamponade? How to recognize its symptoms? What is the treatment?
Cardiac tamponadeis a condition in which exuding fluid or blood builds up in the pericardium (the "bag" that contains the heart). The consequence is a significant increase in pressure in the pericardial sac. Then, not enough blood flows to the heart, and thus - less of it flows from the heart into the vessels supplying organs with oxygen. If a cardiac tamponade is not recognized in time, it will result in cardiac arrest and death.
Depending on how quickly fluid accumulates in the pericardial sac and increases intraocardial pressure, acute and subacute tamponade are distinguished. In the former case, the pressure build-up occurs within a few minutes. In the case of subacute tamponade, the fluid accumulates in the pericardial sac within a few or several dozen hours.
Cardiac tamponade - causes
Cardiac tamponade can be the result of a chest injury (especially in its central part), e.g. a shot, stabbed knife, or hitting the steering wheel in a car accident.
The cause of subacute cardiac tamponade may also be cancer. The pericardial involvement may occur especially in the course of lung cancer, breast cancer and melanoma.
Cardiac tamponade may be one of the first symptoms of a cancer or a systemic disease
People who have pericarditis, rupture of the heart wall as a result of a heart attack, aortic aneurysm rupture, or development of systemic connective tissue disease are also likely to develop cardiac tamponade.
Cardiac tamponade may also indicate end-stage renal or hepatic failure.
The literature also describes the presence of fluid in the pericardium in the course of genetic diseases (Duchenne muscular dystrophy).
Cardiac tamponadecan also be a complicationafter cardiac surgery , e.g. pacemaker implantation, coronography, percutaneous coronary angioplasty (also from stent placement).
Cardiac tamponade - symptoms
- shortness of breath that worsens in the positionlying
- chest pain
- decreased exercise tolerance
The characteristic triad of cardiac tamponade symptoms is low blood pressure, soft heart sounds, and dilation of the jugular veins.
- accelerated heartbeat
- widening of the jugular veins
- low blood pressure
- quiet heart tones
- cough
- swallowing difficulties
- cold pale skin
- fainting and even loss of consciousness
Cardiac tamponade - diagnosis
For the diagnosis of tamponade, an invasive test is performed to measure the endocardial pressure and filling pressures of the left and right chambers of the heart.
Cardiac tamponade - treatment
Cardiac tamponade requires immediate medical intervention. It is necessary to puncture the pericardial sac in order to draw out the excess fluid (known as pericardiocentesis). However, if this procedure is unsuccessful, a pericardiectomy is performed (part or all of the pericardium is removed).