What Is Cardiac Tamponade?
Cardiac tamponade is a serious medical condition in which
blood or fluids fill the space between the sac that encases the heart and the
heart muscle. This places extreme pressure on your heart. The pressure prevents
the heart's ventricles from expanding fully and keeps your heart from
functioning properly. Your heart can’t pump enough blood to the rest of your
body when this happens. This can lead to organ failure, shock, and even death.
Cardiac tamponade is a medical emergency. If you or someone
you know begins experiencing symptoms, seek medical help immediately.
What Causes Cardiac Tamponade?
Cardiac tamponade is usually the result of penetration of
the pericardium, which is the thin, double-walled sac that surrounds your
heart. The cavity around your heart can fill with enough blood or other bodily
fluids to compress your heart. As the fluid presses on your heart, less and
less blood can enter. Less oxygen-rich blood is pumped to the rest of your body
as a result. The lack of blood getting to the heart and the rest of your body
can eventually cause shock, organ failure, and cardiac arrest.
The causes of pericardial penetration or fluid accumulation
- gunshot or stab wounds
- blunt trauma to the chest from a car or
- accidental perforation after cardiac
catheterization, angiography, or insertion of a pacemaker
- punctures made during placement of a central
line, which is a type of catheter that administers fluids or medications
- cancer that has spread to the pericardial sac,
such as breast or lung cancer
- a ruptured aortic aneurysm
- pericarditis, an inflammation of the pericardium
- lupus, an inflammatory disease in which the immune
system mistakenly attacks healthy tissues
- high levels of radiation to the chest
- hypothyroidism, which increases the risk for
- a heart attack
- kidney failure
- infections that affect the heart
What Are the Symptoms of Cardiac Tamponade?
Cardiac tamponade has the following symptoms:
- anxiety and restlessness
- low blood pressure
- chest pain radiating to your neck, shoulders, or
- trouble breathing or taking deep breaths
- rapid breathing
- discomfort that’s relieved by sitting or leaning
- fainting, dizziness, and loss of consciousness
How Is Cardiac Tamponade Diagnosed?
Cardiac tamponade often has three signs your doctor can
recognize. These signs are commonly known as Beck’s triad. They include:
- low blood pressure and weak pulse because the
volume of blood your heart is pumping is reduced
- extended neck veins because they’re having a hard
time returning blood to your heart
- a rapid heartbeat combined with muffled heart sounds
due to the expanding layer of fluid inside your pericardium
Your doctor will conduct further tests to confirm a cardiac
tamponade diagnosis. An echocardiogram is an ultrasound of your heart. It can
detect whether the pericardium is distended and if the ventricles have
collapsed due to low blood volume. Your chest X-rays may show an enlarged,
globe-shaped heart if you have cardiac tamponade. Other diagnostic tests may
- a thoracic CT scan to look for fluid
accumulation in your chest or changes to your heart
- a magnetic resonance angiogram to see how blood
is flowing through your heart
- an electrocardiogram to assess your heartbeat
How Is Cardiac Tamponade Treated?
Cardiac tamponade is a medical emergency that requires hospitalization.
The treatment of cardiac tamponade has two purposes. It should relieve pressure
on your heart and then treat the underlying condition. Initial treatment
involves your doctor making sure you’re stabilized.
Your doctor will also drain the fluid from your pericardial
sac, typically with a needle. This procedure is called pericardiocentesis. Your
doctor may perform a more invasive procedure called a thoracotomy to drain
blood or remove blood clots if you have a penetrating wound. They may remove part
of your pericardium to help relieve pressure on your heart.
You’ll also receive oxygen, fluids, and medications to
increase your blood pressure.
Once the tamponade is under control and your condition stabilizes,
your doctor may perform additional tests to determine the underlying cause of
What Is the Long-Term Outlook?
The long-term outlook depends on how quickly the diagnosis
can be made, the underlying cause of the tamponade, and any subsequent
complications. Your outlook is fairly good if the cardiac tamponade is quickly
diagnosed and treated.
Your long-term outlook greatly depends on how quickly you get
treatment. Seek medical treatment immediately if you think you have this