Pericardial Tamponade is a medical emergency that can be fatal if not treated immediately. It is also known as Cardiac TamponadeIt is triggered when the pericardium encasing the heart and major vessels is overwhelmingly accumulated with air, blood, or other bodily fluids, such that the compression of the heart hinders cardiac motions. Subsequently, the heart’s performance is hindered as it is unable to expand leisurely.
Resultant factors like restricted blood and oxygen supply to the rest of the body can lead to critical medical occurrences ranging from low blood pressure to shock and even death.
Causes Of Pericardial Tamponade
Pericardial Tamponade can result from injuries, whether a ruptured aortic aneurysm, blunt traumatic incidents like a car or industrial accidents, or penetrating trauma like gunshot or stab wounds. Patient’s bodies with some medical diseases can also become vulnerable to this condition.
These include advanced cancer, heart attack, tuberculosis, pericarditis, hypothyroidism, kidney failure, scleroderma, rheumatoid arthritis, and lupus. Medical procedures around the heart can also face pericardial Tamponade as an after-effect, whether surgery, pacemaker (device placement), or radiation to the chest.
Symptoms Of Pericardial Tamponade
Symptoms of the Tamponade depend on its severity and cause. It may occur suddenly or slowly over time, and the signs will vary in intensity accordingly. The patient may experience shortness of breath, dizziness, low blood pressure, skin going pale or blue or even jaundice, bulging neck veins, swelling in the abdomen or legs, sharp pain in the chest or areas around it, irregular pulse, heart palpitations, and a disturbed mental status.
Diagnosis Of Pericardial Tamponade
Pericardial Tamponade can be recognized based on Beck’s triad. However, a prompt and accurate clinical diagnosis is crucial to prevent the condition from escalating to possibly even a cardiovascular collapse. Thus, extended tests besides the apparent physical exam are conducted for confirmation purposes. These include:
- Electrocardiogram (EKG) helps gauge heartbeat patterns,
- Chest X-rays show the size and shape of the heart, and doctors can recognize a globe-shaped heart, also referred to as the ‘water bottle sign,’ as going through cardiac Tamponade.
- An echocardiogram is a heart ultrasound showing the pericardium’s swollen and helps gauge heartbeat patterns.
- Thoracic CT scans can detect if blood is gathered in the chest or if there are other circulatory issues.
- A Magnetic Resonance Angiogram can observe the flow of blood.
- Heart catheterization involves inserting a device into an artery to view the process inside the heart and blood vessels.
Besides detecting the condition, it is also important to discover the cause behind it to understand what better can be done as cautionary measures to prevent it from recurring. For this, the following tests can be carried out by respective healthcare providers:
- Blood tests help detect if there is any inflammation or infection, as well as if the patient has any autoimmune disease or any metabolic problems.
- The fluid removed in the treatment procedure can also be studied to check for cancer.
Treatment Of Pericardial Tamponade
Since the disease is a medical emergency, speedy and appropriate treatment is the priority. The Tamponade is dealt with removing the pericardial fluid, called pericardiocentesis. It involves inserting a needle and a long thin tube called a catheter into the chest to draw the fluid out. Another practice is the pericardial window, in which surgeons drain the pericardial sac and may even have to remove part of the pericardium.
Treatments besides fluid removal involve therapies designed to address the cause of the fluid buildup, for example, chemotherapy in case of cancer. Blood transfusion is a therapy adopted in cases where the reason is trauma or the complication of open heart surgery. Medication or IV therapy is certain other treatment option to raise blood pressure, reduce pain, decrease inflammation, and strengthen heart pulse.
Complications Of Pericardial Tamponade
Pericardial Tamponade is a condition that, if treated timely and precautions and therapy observed afterward, often does not cause further complications. However, if the situation escalates, severe consequences like organ failure or even the cessation of all vital functions will have to be borne. The complications include pulmonary edema, shock, organ failure, cardiac arrest, and death.
References
- https://my.clevelandclinic.org/health/diseases/21906-cardiac-tamponade
- https://emedicine.medscape.com/article/152083-overview
- https://www.ncbi.nlm.nih.gov/books/NBK431090/
- https://www.healthline.com/health/cardiac-tamponade
- https://www.osmosis.org/answers/pericardial-tamponade
- https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cardiac-tamponade.html
