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Cardiac Tamponade

  • Normal Heart

Definition

Cardiac tamponade is a build-up of fluid in the pericardium, which is the thin membrane around the heart. This build-up obstructs the flow of blood into the heart, which prevents the lower chambers of the heart, called the ventricles, from filling.

What is going on in the body?

The pericardium normally contains a very small amount of fluid. It plays an important role in the following ways:
  • It helps the upper chambers of the heart, called the atria, fill with blood while your heart is beating.
  • It maintains the position of the heart within the chest.
  • It minimizes friction between the heart and surrounding structures.
Chest trauma, such as a crush injury, can cause blood or other body fluids to build up in the pericardium..When this fluid builds up around the heart, it restricts the ability of the ventricles to fill with blood. If the build-up of fluid occurs slowly over time, then large amounts of fluid can collect. However, if fluid collects suddenly, even small amounts may be fatal.

Risks

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

Prevention

What can be done to prevent the condition?

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

Diagnosed

How is the condition diagnosed?

The diagnosis can be made by the presence of abnormal pulses and an abnormal electrocardiogram, also known as an ECG. A chest X-ray may show changes in the shape of your heart. Echocardiography (an ultrasound examination of the heart), or more invasive tests such as cardiac catheterization can confirm the diagnosis.

Long Term Effects

What are the long-term effects of the condition?

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

Other Risks

What are the risks to others?

There are no risks to others.

Treatments

What are the treatments for the condition?

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

Side Effects

What are the side effects of the treatments?

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

After Treatment

What happens after treatment for the condition?

After treatment, the healthcare provider needs to watch closely in case fluid starts to build up again. If that happens, the procedure will need to be repeated. The underlying disease must be aggressively treated.

Monitor

How is the condition monitored?

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

Sources

Harrison's Principals of Internal Medicine, 1991

Current Medical Diagnosis and Treatment

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