Definition

Cardiac tamponade occurs when fluid builds up between the heart muscle and the surrounding tissue called the pericardium. This fluid compresses the heart. Because of this, enough blood cannot be pumped in and out of the heart.

This condition can be life-threatening. Cardiac tamponade can be treated, but it can return after treatment.

Causes

Cardiac tamponade can be caused by a variety of factors and conditions, including:

• Pericarditis —an inflammation of the sac that surrounds the heart, caused by bacterial or viral infections
• Bleeding into the pericardium, caused by injury
• Ruptured heart muscle
• Cancer in or near the heart

Risk Factors

Factors that may increase your chance of cardiac tamponade include:

• Heart surgery
• Tumors in the heart
• Heart attack
• Injury to the heart
• End-stage lung cancer
• Kidney failure
• Radiation therapy to the chest
• Hypothyroidism
• Systemic lupus erythematosus

Symptoms

Symptoms vary from mild to severe. They typically include one or more of the following:

• Fatigue or drowsiness
• Shortness of breath, rapid breathing, or difficulty breathing
• Lightheadedness
• Chest pain:
  • That extends to the neck, shoulders, or abdomen
  • Sharp or stabbing pain
  • Pain that is worsened by coughing or deep breathing
• Discomfort that can be relieved by sitting upright or leaning forward
• Swelling of the abdomen, veins in the arms or legs, or other areas
• Pale skin, or skin that is blue- or gray-tinted
• Rapid heartbeat
• Anxiety or restlessness
• Fainting
• Feeling of weakness
• General discomfort

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. If you have a significant change in blood pressure between breaths, this is one way your doctor will diagnose this condition.

• Imaging tests to evaluate the heart and surrounding structures may include:
  • Chest x-ray
  • Echocardiogram
  • CT scan
  • MRI scan
  • Coronary angiography
• Your doctor may need to test your heart activity. This can be done with:
  • Cardiac catheterization
  • Electrocardiogram (EKG)

Treatment

Cardiac tamponade is a serious condition. It can be life-threatening and requires immediate hospitalization and treatment.

Treatments are given to:

• Save the person’s life
• Improve heart function
• Relieve symptoms

Treatments that are given for cardiac tamponade include:

• Pericardiocentesis —a procedure to drain the fluid around the heart
• Fluids to maintain normal blood pressure
• Antibiotics to fight bacterial infection
• Medications to help increase blood pressure to normal levels
• Oxygen to reduce workload on the heart
• Surgery to remove or cut part of the pericardium

Prevention

There are no current guidelines to prevent cardiac tamponade.

National Heart Lung and Blood Institute http://www.nhlbi.nih.gov/

Heart and Stroke Foundation of Canada http://www.heartandstroke.com/

Explore pericarditis. National Heart Lung and Blood Institute website. Available at:
http://www.nhlbi.nih.gov/health/health-topics/topics/peri
Accessed January 23, 2013.

Pericardial effusion. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed
Updated October 15, 2010. Accessed January 23, 2013.