Cardiac tamponade occurs when fluids or blood build up in the space between the myocardium (heart muscle) and pericardium (outer covering sac of the heart) leading to increased pressure. In cases of cardiac tamponade the heart cannot fully function. The fluid accumulation in the pericardium prevents the ventricles from fully expanding and filling thus, consequently, the rest of the body does not get enough oxygen-rich blood.
Cardiac tamponade is considered a serious medical condition and requires immediate medical assistance. If not treated immediately, complications such as, pulmonary edema, shock and death, may arise. Cardiac tamponade may also be referred to as pericardial tamponade.
Causes of Cardiac Tamponade
The common cause of cardiac tamponade is penetration of the pericardium (wounds to the heart). Fluid or blood accumulation in the pericardium can occur due to:
- Pericarditis (may be caused by either bacterial or viral infections)
- Heart surgery
- Heart attack
- Dissecting aortic aneurysm (thoracic)
- Lung cancer that is already in its end stage
Two out of 10,000 cases of cardiac tamponade are due to medical conditions. Secondary causes of cardiac tamponade include:
- Recent invasive heart procedures or open heart surgery
- Heart tumor
- Kidney failure
- Hypothyroidism
- Systemic lupus erythematosus (SLE)
- Leukemia
- Central lines placement
Signs and Symptoms of Cardiac Tamponade
The classic signs and symptoms of cardiac tamponade have Beck’s triad: low blood pressure, increased venous pressure and muffled heart tones. The following signs are usually characteristic of a cardiac tamponade:
- Fall in blood pressure when the person inhales deeply
- Distended neck veins
- Rapid breathing
- Tachycardia (heart rate over 100)
- Faint heart sounds upon examination
- Weak or absent peripheral pulses
The following symptoms may or may not be present in cases of cardiac tamponade. These include:
- Chest pain that may radiate to the shoulder, neck, abdomen or back
- Sharp or stabbing chest pain that is exacerbated by coughing or deep breathing
- Rapid breathing that may be difficult
- Discomfort that may be relieved by leaning forward or sitting upright
- Palpitations but the pulse may be weak or absent
- Pale, gray or bluish skin
- Abdominal swelling that may also occur in other body parts
- Syncope (fainting) and/ or light headedness
- Drowsiness
- Dizziness
- Anxiety that may be accompanied by restlessness
First Aid Treatment for Cardiac Tamponade
Because cardiac tamponade is a medical emergency, it may require the complete care from medical professionals to keep the patient stable. When a patient is suspected of cardiac tamponade, it is recommended to do the following:
- Immediately call medical assistance.
- Apply direct pressure to the wound if there is bleeding. This will help stop the bleeding. Use a clean dressing or absorbent cloth. Keep the pressure in place and apply new cloth over the old one rather than removing the soaked dressing to avoid disturbing the wound.
- Check for the victim’s circulation, airway, breathing, disability/ deformity and exposure.
- Check for the victim’s pulse by the groove on the neck. If no pulse is detected, initiate CPR.
- If the victim is unconscious, ensure that there is no obstruction in the airway. Turn the victim’s head to the side.
- To check for breathing, position own cheek a few inches from the victim’s nose and mouth. Feel for air and watch for rise and fall of chest. Begin rescue breathing if necessary.
- Be prepared to treat the victim for shock.
Cardiac tamponade occurs when there is pressure in the heart due to accumulation of fluid in the pericardium. Classically, the patients will present with Beck’s triad.