Cardiac tamponade

Cardiac tamponade is when fluid collects around the heart muscle, for instance, due to trauma. It puts strain on the heart and stops it working effectively. Symptoms include a drop in blood pressure and distended blood vessels. It needs urgent treatment. In people with cardiac tamponade, also known as pericardial tamponade, fluid or blood builds up between the heart and the sac that surrounds the heart. This sac is called the pericardium. The pericardium consists of two thin layers of tissue. This area usually contains a small amount of fluid to prevent friction between the layers. However, an abnormally high level of fluid puts pressure on the heart and affects its ability to pump blood around the body properly. If the level of fluid builds up quickly, the condition can be life threatening. Doctors consider cardiac tamponade to be a medical emergency. In this article, we discuss the causes and symptoms of cardiac tamponade. We also describe the treatment options and the outlook for people with this condition. Share on Pinterest Medical Illustration by Diego Sabogal Cardiac tamponade results from the rapid buildup of blood or another fluid between the layers of the pericardium. This buildup of fluid around the heart is also known as The causes of cardiac tamponade • severe chest injury • • • • • • • • • the bursting of an aortic • cancer Complications arising from heart surgery may also cause cardiac tamponade. According to Share on Pinterest Carol Yepes/Getty Images Cardi...

What is cardiac tamponade? Cardiac tamponade happens when extra fluid builds up in the space around the heart. This fluid puts pressure on the heart and prevents it from pumping well. This is a medical emergency. A fibrous sac called the pericardium surrounds the heart. This sac is made up of 2 thin layers. Normally, a small amount of fluid if found between the 2 layers. The fluid prevents friction between the layers when they move as the heart beats. In some cases, extra fluid can build up abnormally between these 2 layers. If too much fluid builds up, the extra fluid can make it hard for the heart to expand normally. Because of the extra pressure, less blood enters the heart from the body. This can reduce the amount of oxygen-rich blood going out to the body. If the fluid builds up around the heart too quickly, it can lead to short-term (acute) cardiac tamponade. It's life-threatening if not treated right away. Another type of cardiac tamponade (subacute) can happen when the fluid builds up more slowly. This is also life-threatening. Cardiac tamponade is rare. But anyone can develop this health problem. What causes cardiac tamponade? Cardiac tamponade results from fluid buildup in the sac around the heart. This fluid buildup is called a pericardial effusion. Often the pericardial sac also becomes inflamed. Some health issues that can cause this fluid buildup are: • Infection of the pericardial sac such as during a viral or bacterial illness • Cancer • Inflammation of the...

• Overview   • • Theory   • Epidemiology • Aetiology • Case history • Diagnosis   • Approach • History and exam • Investigations • Differentials • Criteria • Management   • Approach • Treatment algorithm • Patient discussions • Follow up   • Monitoring • Complications • Prognosis • Resources   • Guidelines • • Patient leaflets Cardiac tamponade is a medical emergency; can be rapidly fatal if not promptly drained through needle pericardiocentesis or surgical drainage of the pericardium. Clinical signs include tachycardia, hypotension, distant heart sounds, elevated jugular venous pressure, and a pulsus paradoxus >10 mmHg. Echocardiography is essential for evaluation. Cardiac tamponade may be caused by any disorder that results in pericardial effusion. Pericardiocentesis may be complicated by puncture or laceration of the coronary, internal mammary, or pericardial blood vessels. Definition Cardiac tamponade is the accumulation of pericardial fluid, blood, pus, or air within the pericardial space that creates an increase in intra-pericardial pressure, restricting cardiac filling and decreasing cardiac output. Cardiac tamponade is a cardiac emergency and can be fatal if it is not quickly diagnosed and treated promptly. LeWinter MM, Kabbani S. Pericardial diseases. In: Zipes DP, Libby P, Bonow P, et al. Braunwald's heart disease: a textbook of cardiovascular medicine. 7th ed. Philadelphia: WB Saunders; 2005:1757-1781. The diagnosis is based on clinical suspicion and...

rapid reference Key tests to consider in evaluation of tamponade are listed below. However, perhaps more important than any individual test is a thorough global evaluation of the patient (including exclusion of alternative causes of shock). pulsus paradoxus >10 mm 📖 • Good sensitivity (but false-negatives occur in hypovolemia, LV failure, aortic regurgitation, or mechanical ventilation). • Nonspecific (also seen in RV dysfunction, asthma, COPD, severe hypovolemia, extreme obesity). IVC dilation • Highly sensitive, but may be absent in low-pressure tamponade. • Nonspecific (also seen in RV failure, volume overload). right atrial collapse 📖 • Any degree of atrial collapse is reasonably sensitive, but nonspecific. • If the right atrium is collapsed most of the time, this is more specific for tamponade. right ventricular diastolic collapse • Very sensitive, but may be absent in coexisting RV dysfunction (e.g., pulmonary hypertension). • Very specific, but can also be caused by hypovolemia or large pleural effusion. limitations of this chapter There is no single gold-standard test or diagnostic criteria to determine the presence or absence of tamponade (indeed, tamponade actually exists on a spectrum, rather than as a single dichotomous variable!). Perhaps the closest thing to a gold standard would be clinical improvement after therapeutic drainage. For obvious reasons, this gold standard cannot be applied to most studies of tamponade. Therefore, it's largely impossible to obta...

• Home • Curriculum Portal • Cardio Topics • Directory • Aortic Disease • 2014 CCS Thoracic Aortic Disease Guideline Summary • Aortopathy • Arrhythmia and Device Therapy • Atrial Fibrillation • Bradycardia – Diagnosis • Bradycardia – Management • Cardiac Implantable Devices for Residents • Supraventricular Tachycardia • Narrow QRS Tachycardia • Narrow QRS Regular Tachycardia • Sinus Tachycardia • Atrial Tachycardia • Syncope • Cardiac Syncope Management • Driving Guidelines for Arrhythmia/Syncope • Wide Complex Tachycardia – Diagnosis • Wide Complex Tachycardia: Management • Cardiac Critical Care • Aortic Dissection • Cardiogenic Shock • Cardiac Tamponade • Resuscitation After Cardiac Surgery • Pulmonary Artery Catheterization • Temporary Pacing • Coronary Artery Disease • Stable CAD • Non-STE ACS (NSTEMI/UA) • ST Elevation MI (STEMI) • Thrombolysis in STEMI • Acute Coronary Syndrome: ACE Inhibitors, Beta Blockers, MRAs • Post-MI Care • CAD: Fitness to Drive & Fly • Complications of Myocardial Infarction • Heart Failure • Acute Heart Failure • Chronic Heart Failure • Valvular Heart Disease • Aortic Stenosis • Aortic Stenosis Intervention • Aortic Regurgitation • Mitral Regurgitation • Mitral Stenosis • Mitral Stenosis Intervention • Prosthetic Valves • Endocarditis • Non-Bacterial Thrombotic Endocarditis (NBTE) • Pericardial/Myocardial Disease • Pericarditis • Cardiac Tamponade • Hypertrophic Cardiomyopathy • Takotsubo Cardiomyopathy • Pulmonary Disease • Pulmonary Hyperte...

Pericardiocentesis is a procedure where a healthcare provider inserts a needle into the pericardium, a pouch that surrounds your heart. This procedure has life-saving potential when you have pericardial effusion (too much fluid in the pericardium) and cardiac tamponade (when your heart doesn’t have enough room to beat because of fluid buildup). Overview How pericardiocentesis drains excess fluid from around the heart.. What is this procedure? Pericardiocentesis (pair-ick-arr-dee-oh-sen-tee-sis) is a procedure that involves draining fluid from around your heart. It’s often an emergency treatment for cardiac tamponade, a life-threatening condition that can stop your heart. This procedure involves inserting a needle into your chest until the tip of the needle is inside your pericardium. Once there, providers can use the needle to drain fluid directly or place a drain that can remove fluid slowly over time. Why would someone need this treatment? Your heart sits inside the pericardium, a liquid-filled pouch that holds your heart in place and cushions it from outside movement. Under normal circumstances, there’s plenty of room in the pericardium. That means your heart can expand and fill up with blood between heartbeats. Pericardial effusion is when the pericardium fills up with too much fluid, which means there’s less space for your heart to expand between heartbeats. When an effusion happens slowly, your pericardium has time to stretch and accommodate the additional fluid. Whe...