Cardiac Tamponade

Overview, Causes, & Risk Factors

Cardiac tamponade is a build-up of fluid in the pericardium, which is thethin membrane around your heart. This build-up obstructs the flow of blood into your heart.And that means that the lower chambers of your heart, called the ventricles, cannot fill.

What is going on in the body?

The pericardium normally contains a very small amount of fluid. It plays animportant role in the following ways:

  • It helps the upper chambers of your heart, called the atria, fill with blood while your heart isbeating.
  • It maintains the position of your heart within the chest.
  • It minimizes friction between your heart and surrounding structures.
  • Chest trauma, such as a crush injury,can cause fluid to build up in the pericardium. The accumulated fluid consists of bloodor other body fluids. When this fluid builds up around your heart, it restricts theability of the ventricles to fill with blood. If the build-up of fluid occurs slowly over time, thenlarge amounts of fluid can collect. However, if fluid collects suddenly, even small amountsmay be fatal.

    What are the causes and risks of the condition?

    Cardiac tamponade can occur after any of the following events or conditions.

  • crush injury, such as a motor vehicle accident
  • infection
  • massive heart attack
  • surgery
  • tuberculosis
  • tumors
  • If the cardiac tamponade is not treated, you may die.

    Symptoms & Signs

    What are the signs and symptoms of the condition?

    Although the onset of cardiac tamponade can be sudden, it most commonlyoccurs slowly. The symptoms increase with the amount of blood in the pericardium. Asyour heart stops pumping efficiently, these symptoms appear:

  • abnormal pulse, especially when you breathe in
  • chest pain
  • cough
  • hoarseness
  • liver congestion and pain
  • rapid heart rate
  • shock
  • shortness of breath
  • Diagnosis & Tests

    How is the condition diagnosed?

    The diagnosis can be made by the presence of abnormal pulses and anabnormal electrocardiogram,also known as an ECG. A chest X-raymay show changes in the shape of your heart. Echocardiography,which is an ultrasound of your heart, or more invasive tests such as cardiac catheterizationcan confirm the diagnosis.

    Prevention & Expectations

    What can be done to prevent the condition?

    Early treatment of any underlying heart disease or infection can helpprevent cardiac tamponade. Drainage of fluid from the pericardium before too muchbuilds up can also prevent tamponade.

    What are the long-term effects of the condition?

    If the tamponade is not discovered in time, the fluid build-up into the pericardiumwill finally stop your heart from filling properly, and death may result.

    What are the risks to others?

    There are no risks to others.

    Treatment & Monitoring

    What are the treatments for the condition?

    A needle placed into the pericardium can drain the fluid. Sometimes achest tube is left in place to allow continuous drainage.

    What are the side effects of the treatments?

    The needle drainage of fluid out of the pericardium is associated with anincreased risk of infection and perforation of the wall of the heart or lung.

    What happens after treatment for the condition?

    After treatment, your doctor will watch you carefully because fluid may build upagain. If that happens, the procedure will need to be repeated. The underlying diseasemust be aggressively treated.

    How is the condition monitored?

    If the tamponade is caused by a sudden chest trauma and is successfullydrained, then the risk of more fluid build-up lessens. Any underlyingheart infection must be treated to make sure that fluid does not build up again.

    Article type: xmedgeneral