Cardiac Tamponade: Causes, Symptoms, Treatment

What is Cardiac Tamponade?

Cardiac Tamponade is an emergent medical condition characterized by accumulation of excessive fluid in the pericardium. When this happens, the fluid puts extra pressure on the heart which makes it tough for the heart to pump blood to the body. This ultimately results in the body going into a shock and even cardiac arrest which most of the times can be fatal for the person.[1,2,3]

Cardiac Tamponade requires prompt diagnosis and treatment to save the life of the patient. This treatment can either be given at the bedside or may require a surgical procedure. Anatomically speaking, the pericardium has two layers of tissue. This area normally contains some fluid to prevent friction between the two layers. Cardiac Tamponade results when the levels of this fluid rapidly become abnormally high exerting excessive pressure on the heart.[1,2,3]

What Causes Cardiac Tamponade?

As stated, Cardiac Tamponade occurs when there is a buildup of fluid in the pericardium. It is of two types namely acute and subacute. An acute Cardiac Tamponade occurs when there is a rapid buildup of fluid while subacute Cardiac Tamponade occurs when there is a gradual buildup of fluid in the pericardium.[2,3]

The most common causes of Cardiac Tamponade include a severe chest injury such as in a motor vehicle crash, gunshot or a stab wound. Myocardial infarction is yet another cause of Cardiac Tamponade. People with hypothyroidism can also get this condition. People with a medical condition called pericarditis which is caused due to inflammation of the pericardium can also cause fluid to build up and cause Cardiac Tamponade.[2,3]

People with a history of kidney failure or tuberculosis are also at risk for developing Cardiac Tamponade. Additionally, a person who has undergone a cardiac surgery is also at risk for developing Cardiac Tamponade postsurgery. Studies estimate around 6% of people with a history of cardiac surgery develop Cardiac Tamponade.[2,3]

What are the Symptoms of Cardiac Tamponade?

As stated, Cardiac Tamponade interferes with the ability of the heart to pump blood in the body. This leads to a variety of symptoms due to poor circulation of blood. This causes chest pains and dizziness. Cardiac Tamponade has three classic signs called the Beck’s triad. These signs are low pressure in the arteries, muffled heart sounds, and bulging of neck pains.[3]

Additionally, a person with Cardiac Tamponade will also have a weak pulse along with bluish discoloration of the skin. The person will feel drowsy and may even pass out. There will be heightened anxiety and breathing will be very difficult.[3]

How is Cardiac Tamponade Treated?

As stated, Cardiac Tamponade is an emergent medical condition and requires immediate emergency room visit since it may cause shock and the loss of life. The primary focus of treatment is to drain out the excess fluid from the pericardium and release pressure on the heart. For this, the following approaches may be taken.[3]

The first one is called pericardiocentesis. This approach involves using a needle to drain fluid from the pericardium. The second approach is pericardectomy in which the pericardium is removed surgically and pressure is released from the heart. Thoracotomy is yet another treatment approach in which excess fluid is drained from the pericardium.[3]

Experts believe that minimally invasive methods need to be used as a first line of treatment since it has less mortality rates and there are less chances of a postsurgical complication. However, severe cases of Cardiac Tamponade require surgery to drain the excess fluid.[3]

Postsurgery, the patient will be given IV fluids and medications to maintain normal blood pressure. The patient may also require oxygen therapy to relieve shortness of breath. Once the patient has been stabilized, then the underlying cause of Cardiac Tamponade is identified and treatment is started for it.[3]

Is Cardiac Tamponade Common?

Cardiac Tamponade may affect anyone but it is not a common condition. A study done in 2018 stated that only 5 in 10,000 hospital admissions were for Cardiac Tamponade in the United States. However people with certain medical conditions are more at risk. These include kidney disease, history of heart failure, HIV, tuberculosis, and chest injuries. People with these preexisting conditions should look out for the signs and if present get checked up for Cardiac Tamponade.[3]

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