Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium).
Tamponade; Pericardial tamponade
In this condition, blood or fluid collects in the pericardium, the sac surrounding the heart. This prevents the heart ventricles from expanding fully. The excess pressure from the fluid prevents the heart from functioning normally. As a result, the body does not receive enough blood.
Cardiac tamponade can occur due to:
Other possible causes include:
Cardiac tamponade occurs in about 2 out of 10,000 people.
Other symptoms that may occur with this disorder:
There are no specific laboratory tests that diagnose tamponade. Echocardiogram is typically used to help establish the diagnosis. In emergency cases, echocardiogram is done at the bedside.
Other tests may include:
Cardiac tamponade is an emergency condition that requires hospitalization.
The fluid around the heart must be drained as quickly as possible. Pericardiocentesis is a procedure that uses a needle to remove fluid from the pericardial sac, the tissue that surrounds the heart.
A procedure to cut and remove part of the pericardium (surgical pericardiectomy or pericardial window) may also be done.
Fluids are given to maintain normal blood pressure until pericardiocentesis can be performed. Medications that increase blood pressure may also help sustain the patient's life until the fluid is drained.
The patient may be given oxygen. This reduces the workload on the heart by decreasing tissue demands for blood flow.
The cause of tamponade must be identified and treated.
Cardiac tamponade is a medical emergency. If the fluid or blood is not quickly removed from the pericardium, death can occur quickly.
The outcome is often good if the condition is treated promptly, but tamponade may come back.
Go to the emergency room or call the local emergency number (such as 911) if symptoms develop. Cardiac tamponade is an emergency condition requiring immediate attention.
Many cases are not preventable. Awareness of your personal risk factors may allow early diagnosis and treatment.
LeWinter MM, Tischler MD. Pericardial diseases. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadlephia, Pa: Saunders Elsevier; 2011:chap 75.
Little WC, Oh JK. Pericardial diseases. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 77.
Harper RJ. Pericardiocentesis. In: Roberts JR, Hedges JR, eds. Clinical Procedures in Emergency Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 16.