Cardiac Tamponade

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Cardiac tamponade is a medical condition in which fluid accumulates in the pericardial space surrounding the heart. This is a medical emergency because the heart is experiencing increased pressure as a result of build or build. Without treatment, cardiac tamponade can be fatal.

Acute causes: 

• Chest trauma/injury

• Idiopathic (no known causes)

• Myocardial infarction (MI) 

• Pericarditis

• Heart surgery generally caused by a  post-surgical complications

Chronic causes:

• Cancer.

• CKD related uremia

• Connective tissue disorders such as rheumatoid arthritis (RA) and Lupus. 

• Tuberculosis (TB): a complication from TB. 

The accumulation of fluid in the pericardial space raises the heart's intracardiac pressure, impairing its ability to pump blood. Additionally, there is a decrease in blood flow through the heart.

• Pericarditis: Individuals with a history of previous pericarditis (inflammation of the pericardium)

• Cancer

• Heart failure

• Kidney failure

• Radiation therapy: radiation therapy performed around the heart area

• Shortness of breath 

• Chest pain

• Tachycardia 

• Tachypnea

• Weakness 

• Dizziness

Diagnosis starts with a physical examination of the patient and a good history.

Investigations may include: 

• ECG 

• CXR - fluid in the pericardial space can be observed 

• ECHO 

• CT SCAN 

• MRI 

• Cardiac catheterisation

• Culture of fluid from a pericardiocentesis

• Medical emergency - patient must be admitted to the hospital 

• Pericardiocentesis: drainage of fluid in the pericardial space through a needle or a catheter inserted through the chest into the pericardial space. 

• Treat underlying causes such as TB, pericarditis, MI etc.