Cardiac tamponade may be a life-threatening condition during which an accumulation of fluid within the sac disrupts the traditional function of the guts .
The fluid that causes tamponade is typically either a typical pericardial effusion (that is, the buildup of an abnormal amount of fluid within the sac ) or bleeding into the pericardial sac. tamponade can appear acutely, or it’s going to develop rather gradually. In either case, symptoms are usually quite striking, and therefore the resolution of symptoms requires the expeditious removal of the surplus fluid from the sac .
How Is tamponade Produced?
Cardiac tamponade occurs when increased pressure within the sac , caused by the surplus fluid, becomes sufficient to limit the filling of the guts during diastole. Since the guts can not fill completely, less blood is ejected with each heartbeat, and therefore the heart has got to work much harder to provide the body’s needs. Furthermore, the oxygenated blood returning to the guts from the lungs tends to copy , producing congestion within the lungs and veins.
The amount of pericardial fluid which is important to supply tamponade depends on how rapidly the fluid has accumulated. If pericardial fluid increases rapidly, the pericardium doesn’t have time to “stretch,” and therefore the pressure within the pericardial cavity can increase greatly—even with a comparatively bit of fluid. On the opposite hand, if the pericardial fluid accumulates more gradually (say, over a period of days or weeks), the pericardium has time to stretch bent accommodate the additional fluid. during this case, the pressure within the pericardial cavity might not increase substantially until the pericardial effusion has become quite large, to the purpose at which the pericardium is incapable of stretching any longer .
What Are The Causes of Cardiac Tamponade?
Cardiac tamponade are often caused by any of the conditions that produce pericardial effusion. These include:
- Dressler’s syndrome
- Infections (viral, bacterial, or fungal)
- Autoimmune diseases like lupus
- Chest trauma thanks to accident or surgical trauma
- Radiation therapy to the chest area
- Aortic dissection
- Drugs (especially hydralazine, isoniazid, and procainamide)
What Are The Symptoms of Cardiac Tamponade?
The type and severity of symptoms depend upon whether the tamponade has developed acutely or gradually. Acute tamponade is most typically produced by chest trauma, cardiac surgery or other invasive cardiac procedures, like cardiac catheterization, or by aortic dissection. altogether these conditions, blood can fill the sac during a matter of seconds or minutes, producing a rapid and severe cardiac compromise. Because the surplus fluid (that is, blood) within the sac accumulates rapidly in these conditions, tamponade can develop even with a comparatively bit of pericardial fluid. Symptoms are immediately striking and severe. pain , severe shortness of breath, and tachycardiaand palpitations are common. Very low vital sign may occur, along side abnormally cool skin, bluish skin discoloration, and reduced output of urine.
Cardiac tamponade that results from conditions aside from trauma, medical procedures, or aortic dissection tends to develop somewhat more gradually, usually over days or weeks. The pleural effusions in these “sub-acute” cases tend to be much larger than in acute cases since the pericardium usually has time to stretch bent accommodate the more gradual fluid accumulation. Symptoms also are less dramatic. Patients with sub-acute tamponade generally experience chest fullness or discomfort, easy fatigue-ability, shortness of breath with minimal activity, and edema within the legs and feet. But while symptoms may develop less dramatically than with acute tamponade, they will eventually become quite severe. This more gradual sort of tamponade also can become fatal, and expeditious treatment remains necessary.
How Is tamponade Diagnosed?
The doctor will usually suspect tamponade by taking note of the patient’s symptoms, by the clinical circumstances (such because the suspected presence of any of the medical conditions known to cause tamponade), and by the physical examination. Additional clues are often obtained with a chest x-ray and an electrocardiogram. Once this condition is suspected, the diagnosis are often readily confirmed with an echocardiogram.
Clinically, it’s sometimes difficult to inform the difference between tamponade and an identical condition called constrictive pericarditis, because the symptoms and therefore the physical examination with these two conditions tend to be quite similar. However, most frequently echocardiography can readily distinguish between these two conditions.
How Is tamponade Treated?
The treatment of tamponade is to get rid of the surplus pericardial fluid from the sac . The removal of fluid immediately relieves the pressure within the sac and allows the guts to resume its normal function.1
The removal of pericardial fluid is typically accomplished by means of a pericardiocentesis—that is, draining the fluid through a versatile catheter inserted into the pericardial cavity .2 Alternately, fluid removal are often accomplished through a surgical drainage procedure. Surgical drainage is typically done if, additionally to draining the fluid, a biopsy of the pericardium is required for diagnostic reasons. If the pericardial effusion comes back after it’s been drained, a pericardiectomy (surgical removal of the pericardium) may become necessary to stop further recurrences.