Cardiac tamponade happens when fluid builds up over the heart, often due to an injury. This fluid creates pressure over the heart, making it harder for the heart to pump blood effectively. People with this condition may experience symptoms like hypotension and swollen veins. It requires immediate medical attention.
The heart is surrounded by a protective sac known as the pericardium, which has 2 thin layers of tissue. Normally, there is a tiny quantity of fluid between these layers to help them slide smoothly over each other.
In cardiac tamponade, extra fluid or blood accumulates in this space, putting pressure over the heart. This pressure makes it difficult for the heart to fill with blood and pump it to the rest of the body. If the fluid accumulates rapidly, it can be very dangerous and even life-threatening.
Because of its severity, cardiac tamponade is treated as a medical treatment.
Causes
Cardiac tamponade occurs when blood or other fluids accumulate rapidly in the middle of the surfaces of the pericardium, the sac that surrounds the heart. This condition, also called pericardial effusion, can develop either quickly, leading to severe cardiac tamponade, or more gradually, resulting in subacute pericardial effusion.
Several factors can lead to cardiac tamponade. These include serious chest injuries, heart attacks, and hypothyroidism. Other causes are swelling of the pericardium, known as pericarditis, bacterial infections, aortic dissection, tuberculosis, kidney failure, and lupus. Additionally, the breaking of an aortic aneurysm, cancer, and complications from a heart operation can also result in cardiac tamponade.
Research indicates that it is a factor in 0.1 percent to 6.0 percent of cases where surgical reintervention is required following cardiac surgery.
Symptoms
Cardiac tamponade affects the heart’s ability to force blood effectively, leading to improper blood circulation throughout the body. This disruption can cause various symptoms, including lightheadedness and chest pain.
Healthcare providers often identify cardiac tamponade through 3 classic signs known as Beck’s triad. These include hypotension within the arteries, muffled sounds of the heart, and bulging or swollen neck veins, referred to as distended veins.
In addition to these primary signs, individuals with this condition might experience other symptoms like a quick heart rate, drowsiness, fainting, and anxiety. They may also feel pain in the back, chest, shoulder, or abdomen, and have difficulty breathing, dizziness, or near-fainting. Other indicators can include a decreased pulse and bluish, cold-to-the-touch skin.
Diagnosis
To diagnose cardiac tamponade, a healthcare provider will first check for Hemopericardium signs. This involves measuring the pressure of blood, hearing the heart with a stethoscope, and testing the presence of the veins.
In addition to these initial assessments, the healthcare will likely order further tests to confirm the diagnosis. One common test is an echo, or echocardiogram, which provides detailed images of the heart and can reveal fluid in a collapsed ventricle or the sac of the pericardial. An X-ray may be used to determine if the heart appears unusually large or misshapen because of fluid accumulation.
Blood tests may also be conducted to assess levels of white or red blood cells, inflammatory markers, and specific enzymes released in reaction to heart muscle damage.
Treatment
This is a serious condition that requires immediate medical attention to prevent death. The main treatment includes draining the excess fluid that has accumulated over the heart.
To rule out the fluid & relieve pressure over the heart, healthcare providers may use several methods. One common procedure is pericardiocentesis, where a needle is used to withdraw substances from the pericardial sac. Another option is pericardiectomy, which involves surgically removing the area of the pericardium to reduce pressure. In more severe cases, a thoracotomy may be performed to drain blood or clots from over the heart.
Scientist suggests that minimally intrusive procedures, like pericardiocentesis, are preferred as the initial treatment because they typically carry a lower chance of issues and have lower death rates. However the more complex episodes of this condition may need more invasive surgery like thoracotomy.
After the initial treatment, the patient may receive intravenous (IV) substances to maintain pressure of blood, medicines to heighten pressure of blood, blood products to restore lost blood, and oxygen to decrease stress. Once the patient is stable, the healthcare provider will focus on identifying and treating the basic cause of the cardiac tamponade to prevent further issues.
Depending on the basic cause, the patient may require additional treatments. For example, anti-inflammatory medications like colchicine may be prescribed. A study in 2020, found that patients who took colchicine after pericardiocentesis experienced significant enhancement.
Prevention
While it is not always likely to stop cardiac tamponade entirely, individuals can decrease their chances by taking several precautionary steps. One key approach is to minimize exposure to viral or bacterial infections, which can contribute to the condition. Additionally, managing existing medical conditions, like hypothyroidism and lupus, through proper treatment is important.
Maintaining overall heart health is also beneficial. This can be achieved by eating a nutritious diet and engaging in regular exercise. Regular medical meetings are essential for monitoring health and catching potential issues early. Finally, avoiding smoking can further protect heart health and reduce the risk of developing cardiac tamponade.
Summary
This condition occurs when fluid accumulates around the heart, impairing its ability to pump blood effectively. It can result from various causes, including chest injuries, infections, and cancer, and is diagnosed through tests like echocardiograms and chest X-rays. Treatment typically includes draining the fluid via procedures like pericardiocentesis or surgery. The outlook varies based on the cause and promptness of treatment, with noncancerous cases having a better prognosis. Preventive measures include managing infections, treating underlying conditions, maintaining heart health, and avoiding smoking.
