Cardiac Tamponade: What it is and how to diagnose it- This article explains all about the causes, signs and symptoms, preventions, and treatment of Cardiac Tamponade. If you are here to know about them, go through it completely.
Introduction: What is Cardiac Tamponade?
Cardiac tamponade is defined as an accumulation of fluid in the pericardial cavity which can be potentially fatal.
The most common cause of tamponade is a rupture of the heart associated with myocardial infarction (MI).
This rupture allows for blood to ooze into the pericardium (the sac that surrounds the heart).
The most common symptoms include dyspnea, chest pain, and hypotension.
Different Types of Cardiac Tamponade
There are three types of tamponade: compressive, infiltrative, and transudative.
1. Compressive tamponade: Compressive tamponade may be due to trauma or tumor.
2. Infiltrative tamponade: Infiltrative tamponade may be due to malignant infiltration or mesothelioma.
3. Transudative tamponade: Transudative tamponade results from leakage of fluid from the capillaries in the pericardium into the pleural space.
What Causes Cardiac Tamponade?
Cardiac tamponade occurs when the pressure inside the pericardium is high, and it results in an effusion of fluids in the pericardial space, usually resulting in distention and compression of the heart.
Causes of cardiac tamponade are shock and a reduction in blood volume, leading to an increase in the volume of blood that is ejected against the blood vessels.
This increase in the volume of blood ejected leads to a reduction in blood volume and causes the heart to pump less blood than the body needs. This process is called cardiac tamponade.
What are the Symptoms of Cardiac Tamponade?
There are a variety of signs and symptoms of tamponade, but the most common and recognizable are chest pain and shortness of breath.
Other signs that are uncommon, but may be observed, include cough, loss of appetite, headache, neck swelling, and a high-pitched bruit or thump (a sound that sounds like a “thump” when it is heard in the chest during a physical exam).
In a tamponade patient, the heart is surrounded by a collection of blood that is not draining back to the atria and ventricles.
This can lead to hypotension (low blood pressure), reduced cardiac output, increased cardiac filling pressures (such as pulmonary artery diastolic pressure and pulmonary capillary wedge pressure), and failure to clear fluid from the pericardial space.
The most common cause is a sudden, large volume of pericardial fluid accumulation, usually due to cardiac injury (cardiac contusion or laceration) or massive bleeding.
What's Cardiac Tamponade Diagnosis?
Cardiac tampons can be diagnosed with physical examination, chest x-ray, electrocardiogram, and echocardiogram.
But if no acute symptoms are present, diagnosis is usually obtained with a series of noninvasive procedures including transthoracic and transesophageal echocardiography, cardiac magnetic resonance imaging, computed tomography angiography, and transesophageal echocardiography.
In cardiac tamponade, the cardiac chambers are distorted by a large amount of blood in the pericardial and peritoneal space, causing the heart to be enlarged and thickened, and the left ventricle to be pushed to the right.
Cardiac Tampons Treatment Options
Cardiac tamponade is a hazardous crisis that requires brief diagnosis and treatment.
Patients present with respiratory distress, hypotension, and muffled heart sounds.
A crucial part of the emergency cardiac management of patients with cardiac tamponade is the insertion of a large-bore intravenous (IV) catheter to decompress the pericardial sac and allow for hemodynamic stabilization. Aggressive fluid resuscitation and inotropic support are also required.
The main goal in the treatment of cardiac tamponade is to restore venous return and stabilize the patient.
Treatment for cardiac tamponade consists of draining the fluid from around the heart to give it enough room to fill with blood.
The mainstay of treatment is to pericardiocenteses the fluid collection. This can be done both through a subxiphoid or an anterior approach.
The subxiphoid approach is more common and used to treat symptomatic cardiac tamponades, but it carries a 1% risk of cardiac injury.
The anterior approach carries a 0.1% risk of cardiac injury, but it is less commonly used because it is more difficult to perform.
Prevention of Cardiac Tampons
How do we prevent a cardiac tamponade?
The first step is to prevent the fluid from getting around the heart in the first place. An early, common cause of cardiac tamponade is the accumulation of fluid in a pericardial cyst (cyst).
Cysts occur when the lining of the pericardium, which surrounds the heart, does not close properly after a heart attack.
If someone has a cardiac tamponade, the first step to prevention is to determine if the tamponade is life-threatening or not.
If it is, then the cause of the tamponade needs to be determined and then treated.
The second step to preventing a cardiac tamponade is to know how to recognize it, and to be able to prevent it.
In fact, the only way to prevent a cardiac tamponade is to recognize and treat it early.
It's important to know the signs of cardiac tamponade. And to know that symptoms can be life-threatening and deadly if not treated promptly. If you suspect a cardiac tamponade, call your doctor immediately.
Sources
- Cardiac Tamponade (By Healthline)
- Cardiac Tamponade (By Cedars Sinai)
- What to know about Cardiac Tamponade? (By Medical News Today)
- Cardiac Tamponade (By ncbi.nlm.nih)
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