Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium).
Tamponade; Pericardial tamponade
Causes, incidence, and risk factors
In this condition, blood or fluid collects in the pericardium, the sac surrounding the heart. This prevents the heart ventricles from expanding fully. The excess pressure from the fluid prevents the heart from functioning normally. As a result, the body does not receive enough blood.
Cardiac tamponade can occur due to:
Dissecting aortic aneurysm(thoracic)
End-stage lung cancer
Heart attack (
Pericarditiscaused by bacterial or viral infections
Wounds to the heart
Other possible causes include:
Placement of central lines
Radiation therapyto the chest
- Recent invasive heart procedures
- Recent open heart surgery
Systemic lupus erythematosus
Cardiac tamponade occurs in about 2 out of 10,000 people.
Anxiety, restlessness Chest pain
- Radiating to the neck, shoulder, back, or abdomen
- Sharp, stabbing
- Worsened by deep breathing or coughing
- Difficulty breathing
- Discomfort, sometimes relieved by sitting upright or leaning forward
- Pale, gray, or blue skin
- Rapid breathing
- Swelling of the abdomen or other areas
Other symptoms that may occur with this disorder:
- Weak or absent pulse
Signs and tests
There are no specific laboratory tests that diagnose tamponade.
Blood pressure may fall (pulsus paradoxical) when the person breathes in deeply
Breathing may be rapid
Heart rate may be over 100 (normal is 60 to 100 beats per minute)
Heart sounds are faint during examination with a stethoscope
Neck veins may be abnormally extended (distended) but the blood pressure may be low
Patient may look ill and frightened
Peripheralpulses may be weak or absent
Other tests may include:
Chest CTor MRI of chest Chest x-ray Coronary angiography ECG
Cardiac tamponade is an emergency condition that requires hospitalization.
The fluid around the heart must be drained as quickly as possible.
A procedure to cut and remove part of the pericardium (surgical pericardiectomy or pericardial window) may also be done.
Fluids are given to maintain normal blood pressure until pericardiocentesis can be performed. Medications that increase blood pressure may also help sustain the patient’s life until the fluid is drained.
The patient may be given oxygen. This reduces the workload on the heart by decreasing tissue demands for blood flow.
The cause of tamponade must be identified and treated.
Cardiac tamponade is a medical emergency. If the fluid or blood is not quickly removed from the pericardium, death can occur quickly.
The outcome is often good if the condition is treated promptly, but tamponade may come back.
Heart failure Pulmonary edema Shock
Calling your health care provider
Go to the emergency room or call the local emergency number (such as 911) if symptoms develop. Cardiac tamponade is an emergency condition requiring immediate attention.
Many cases are not preventable. Awareness of your personal risk factors may allow early diagnosis and treatment.