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Cardiac tamponade

Tamponade; Pericardial tamponade; Pericarditis - 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 of the heart.

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Heart, front view
Pericardium
Cardiac tamponade

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Causes

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:

Other possible causes include:

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

Symptoms

Symptoms may include:

Other symptoms that may occur with this disorder:

Exams and Tests

Echocardiogram is the test of choice to help make the diagnosis. This test may be done at the bedside in emergency cases.

A physical exam may show:

Other tests may include:

Treatment

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 (pericardium) 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.

Outlook (Prognosis)

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

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

Possible Complications

Complications may include:

When to Contact a Medical Professional

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.

Prevention

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

Related Information

Pericarditis
Aortic dissection
Heart attack
Acute kidney failure
Radiation therapy
Hypothyroidism
Systemic lupus erythematosus
Heart failure - overview
Pulmonary edema

References

LeWinter MM, Imazio M. Pericardial diseases. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 83.

Little WC, Oh JK. Pericardial diseases. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 77.

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.

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Review Date: 5/15/2018  

Reviewed By: Mary C. Mancini, MD, PhD, Director, Cardiothoracic Surgery, Christus Highland Medical Center, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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