Learn About Cardiac Tamponade

What is the definition of Cardiac Tamponade?

Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle and the outer covering sac (pericardium) of the heart.

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What are the alternative names for Cardiac Tamponade?

Tamponade; Pericardial tamponade; Pericarditis - tamponade

What are the causes of Cardiac Tamponade?

In this condition, blood or fluid collects in the sac surrounding the heart. This prevents the heart ventricles from expanding fully. The excess pressure from the fluid prevents the heart from working properly. As a result, the body does not get enough blood.

Cardiac tamponade can occur due to:

  • Dissecting aortic aneurysm (thoracic)
  • End-stage lung cancer
  • Heart attack (acute MI)
  • Heart surgery
  • Pericarditis caused by bacterial or viral infections
  • Wounds to the heart

Other possible causes include:

  • Heart tumors
  • Underactive thyroid gland
  • Kidney failure
  • Leukemia
  • Placement of central lines
  • Radiation therapy to the chest
  • Recent invasive heart procedures
  • Systemic lupus erythematosus
  • Dermatomyositis
  • Heart failure

Cardiac tamponade due to disease occurs in about 2 out of 10,000 people.

What are the symptoms of Cardiac Tamponade?

Symptoms may include:

  • Anxiety, restlessness
  • Sharp chest pain that is felt in the neck, shoulder, back, or abdomen
  • Chest pain that gets worse with deep breathing or coughing
  • Problems breathing
  • Discomfort, sometimes relieved by sitting upright or leaning forward
  • Fainting, lightheadedness
  • Pale, gray, or blue skin
  • Palpitations
  • Rapid breathing
  • Swelling of the legs or abdomen
  • Jaundice

Other symptoms that may occur with this disorder:

  • Dizziness
  • Drowsiness
  • Weak or absent pulse
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What are the current treatments for Cardiac Tamponade?

Cardiac tamponade is an emergency condition that needs to be treated in the hospital.

The fluid around the heart must be drained as quickly as possible. A procedure that uses a needle to remove fluid from the tissue that surrounds the heart will be done.

A surgical procedure to cut and remove part of the covering of the heart may also be done. This is known as surgical pericardiectomy or pericardial window.

Fluids are given to keep blood pressure normal until the fluid can be drained from around the heart. Medicines that increase blood pressure may also help keep the person alive until the fluid is drained.

Oxygen may be given to help reduce the workload on the heart by decreasing tissue demands for blood flow.

The cause of tamponade must be found and treated.

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What is the outlook (prognosis) for Cardiac Tamponade?

Death due to cardiac tamponade can occur quickly if the fluid or blood is not removed promptly from within the pericardium.

The outcome is often good if the condition is treated promptly. However, tamponade may come back.

What are the possible complications of Cardiac Tamponade?

Complications may include:

  • Heart failure
  • Pulmonary edema
  • Bleeding
  • Shock
  • Death
When should I contact a medical professional for Cardiac Tamponade?

Go to the emergency room or call the local emergency number (such as 911) if symptoms develop. Cardiac tamponade is an emergency condition that needs immediate medical attention.

How do I prevent Cardiac Tamponade?

Many cases can't be prevented. Knowing your personal risk factors may help you get early diagnosis and treatment.

Heart - front view
Pericardium
Cardiac tamponade
What are the latest Cardiac Tamponade Clinical Trials?
Continuous Postoperative Pericardial Flushing After Cardiac Surgery in High Risk Patients With the Haermonics Investigational Device: Study Protocol of the FLUID (FLUsh With Investigational Device) Trial

Summary: In two randomized clinical trials the investigators have demonstrated that continuous postoperative pericardial flushing (CPPF) therapy can reduce postoperative blood loss and bleeding-related complications after cardiac surgery and that CPPF therapy is safe and feasible in an experimental setting. The Haermonics investigational device is a novel medical device that enables CPPF therapy to be used...

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Primary Percutaneous Pericardiotomy for Malignant Pericardial Effusion (PMAP) - A Randomized Study

Summary: Pericardial effusion is a common complication in patients with metastatic malignancy. While pericardiocentesis provide effective relieve from life-threatening situation such as cardiac tamponade, recurrence of pericardial effusion after pericardiocentesis is common. We hypothesize that percutaneous balloon pericardiotomy in addition to standard pericardiocentesis with prolonged drainage can preven...

What are the Latest Advances for Cardiac Tamponade?
Use of Combination of Oral Levothyroxine and Liothyronine in Severe Hypothyroidism With Massive Pericardial Effusion.
Short-term effect of HeartCon left ventricular assist device on the treatment of 20 adult patients with end-stage heart failure.
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Feasibility and safety of bridge therapy with active fixed electrodes connected to external permanent pacemakers for patients with infective endocarditis after lead removal and before permanent pacemaker implantation.
Who are the sources who wrote this article ?

Published Date: April 18, 2022
Published By: Mary C. Mancini, MD, PhD, Cardiothoracic Surgeon, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Hoit BD, Oh JK. Pericardial diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 68.

LeWinter MM, Cremer PC, Klein AL. Pericardial diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli, GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 86.

Mallemat HA, Tewelde SZ. Pericardiocentesis. In: Roberts JR, Custalow CB, Thomsen TW, eds. Roberts and Hedges' Clinical Procedures in Emergency Medicine and Acute Care. 7th ed. Philadelphia, PA: Elsevier; 2019:chap 16.