Cardiac Tamponade Definition, Reason, Symptoms, Treatment & Prevention
Definition
Anatomically, the heart is composed of muscles that are protected by a packing bag called the pericardium. For some reason, the space between the muscles and the pericardium can be filled with blood or fluid. The presence of this fluid makes it difficult for the heart to pump blood throughout the body. This condition is called cardiac tamponade.
Cardiac tamponade can result in a lack of blood supply to all parts of the body. In the medical world, cardiac tamponade is an emergency and requires serious treatment immediately. Epidemiologically, cardiac tamponade occurs in 2 out of 10,000 people.
Cardiac Tamponade Symptom
Symptoms of cardiac tamponade can include:
- Easily tired
- Stabbing chest pain that radiates to the neck, shoulder, back or stomach
- Hard to breathe
- Difficulty breathing or discomfort that improves when standing or sitting
- Dizziness and fainting
- Pale skin, lips, and nails
- pounding
- Swollen legs or stomach
- The skin or eyes look yellow
Cardiac Tamponade Reason
Cardiac tamponade can occur for several reasons, such as:
- Aneurysm tear in the aorta
- Heart attack
- Heart surgery
- Infection of the protective lining of the heart (pericarditis)
- Injuries to the heart
Although less common, cardiac tamponade can also be caused by other conditions. Some of them are the presence of tumors in the heart, decreased function of the thyroid gland, leukemia, radiation to the chest, lupus, dermatomyositis, and heart failure.
Diagnosis
The diagnosis of cardiac tamponade can be established on the basis of medical interviews, physical examinations and supporting examinations.
In medical interviews, usually patients complain of shortness of breath, chest pain or palpitations which lead to impaired heart function.
On physical examination, several conditions can be found, namely:
- Blood pressure drops dramatically when breathing deeply
- Breathing rate increases
- Heart rate above 100X/minute
- Heart sounds are not heard clearly when examined with a stethoscope
- The veins in the neck bulge
- The pulse feels weak
Various investigations will be carried out to confirm cardiac tamponade. These supporting examinations, such as:
- Electrocardiogram (EKG) to see the regularity of the work of the heart
- CT- scan or MRI of the chest to see any abnormalities around the heart such as a tumor or an aneurysm.
- Coronary angiography to evaluate the condition of the coronary arteries that supply the heart.
- Echocardiogram is an ultrasound of the heart that can assess the effectiveness of the heart in pumping blood
- Cardiac catheterization
Cardiac Tamponade Treatment
Cardiac tamponade is an emergency condition that requires immediate treatment. A fluid that fills the space between the heart and the pericardium must be removed immediately to restore the heart’s ability to pump blood.
Evacuation of this fluid can be done by using a needle that penetrates directly into the heart sac or by surgery.
The operation is performed by making an incision in the pericardium so that fluid can exit through this incision. This treatment method is called pericardiectomy or the creation of a pericardial ‘window’.
During the act of removing fluid from the heart sac, additional fluids through an IV must be given. This infusion is done with the aim of keeping blood pressure normal until the fluid that causes cardiac tamponade is removed. Giving oxygen is also recommended to ensure that the oxygenation needs of the body’s cells are still met.
If the exact cause is known, this cause must be handled properly so that cardiac tamponade does not recur in the future.
Complications
Various complications can occur due to inadequate treatment of cardiac tamponade. These complications can be:
- Heart failure
- Pulmonary edema
- Bleeding
- Shock
- Death
Prevention
Handling various diseases that can be risk factors is the right step to prevent cardiac tamponade.