by Diana KohnleEn Espaol (Spanish Version) DefinitionCardiac tamponade occurs when fluid builds up between the heart muscle and the surrounding tissue (called the pericardium). This fluid compresses the heart. Because of this, enough blood cannot be pumped in and out of the heart.This condition can be life-threatening. With proper treatment, prognosis is good. Cardiac tamponade can recur after treatment, though. Cardiac Tamponade 2008 Nucleus Medical Art, Inc. Causes Cardiac tamponade can be caused by a variety of factors and conditions, including: Pericarditis (an inflammation of the sac that surrounds the heart) caused by bacterial or viral infections Bleeding into the pericardium, caused by injuryRuptured heart muscleCancer in or near the heart Risk FactorsThese factors increase your chance of developing this condition. Tell your doctor if you have any of these risk factors:Heart surgeryTumors in the heartHeart attackInjury to the heartEnd-stage lung cancerKidney failureRadiation therapy to the chest HypothyroidismSystemic lupus erythematosus SymptomsSymptoms vary from mild to severe. They typically include one or more of the following: Fatigue or drowsinessShortness of breath, rapid breathing, or difficulty breathingDizziness or light-headedness Chest pain That extends to the neck, shoulders, or abdomenSharp or stabbing painPain that is worsened by coughing or deep breathingDiscomfort that can be relieved by sitting upright or leaning forwardSwelling of the abdomen, veins in the arms or legs, or other areasPale skin, or skin that is blue- or gray-tintedRapid heartbeatAnxiety or restlessness Low blood pressureFaintingFeeling of weaknessGeneral malaise DiagnosisYour doctor will ask about your symptoms and medical history. You will also be examined. If you have a significant change in blood pressure between breaths, this is one way your doctor will diagnose this condition.
The following tests are also used for diagnosis: Echocardiogram a test that uses high-frequency sound waves (ultrasound) to examine the size, shape, and motion of the heart. This is the primary test used to diagnose and manage cardiac tamponade. Cardiac catheterization a tube-like instrument inserted into the heart through a vein or artery (usually in the arm or leg) to detect problems with the heart and its blood supply Chest x-ray a test that uses radiation to take a picture of structures inside the body, especially bones CT scan a type of x-ray that uses a computer to make pictures of structures inside the chest MRI scan a test that uses magnetic waves to make pictures of structures inside the chest Coronary angiography x-rays taken after a dye is injected into the arteries; allows the doctor to look for abnormalities in the arteries Electrocardiogram (ECG, EKG) a test that records the hearts activity by measuring electrical currents through the heart muscle TreatmentThis is a serious condition. It can be life-threatening and requires immediate hospitalization and treatment. Treatments are administered to:
Save the patient's lifeImprove heart functionRelieve symptoms Treatments that are administered for cardiac tamponade include: Pericardiocentesisa procedure to drain the fluid around the heart Fluids to maintain normal blood pressureAntibioticsMedications to help increase blood pressure to normal levelsOxygen to reduce workload on the heartSurgery to remove or cut part of the pericardium PreventionThis condition usually cannot be prevented. However, understanding the risk factors can aid in prevention. RESOURCES: American Heart Associationhttp://www.americanheart.org/presenter.jhtml?identifier=1200000 US National Library of Medicinehttp://www.nlm.nih.gov/ CANADIAN RESOURCES: Canadian Cardiovascular Societyhttp://www.ccs.ca/home/index_e.aspx Heart and Stroke Foundation of Canadahttp://ww2.heartandstroke.ca/Page.asp?PageID=24 References: Braverman A, Sundaresan S. Cardiac tamponade and severe ventricular dysfunction. Ann Intern Med . 1994;120:5:442. Available at: http://www.annals.org/cgi/content/full/120/5/442 . Accessed April 15, 2007. Cardiac tamponade. University of California, San Francisco Department of Medicine website. Available at: http://medicine.ucsf.edu/housestaff/Chiefs_cover_sheets/tamponade.pdf . Accessed April 15, 2007.
Heart disease: pericarditis. The Mayo Clinic website. Available at: http://mayoclinic.com/health/pericarditis/DS00505/DSECTION=6 . Accessed April 15, 2007.
Last reviewed April 2008 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.