Cardiac tamponade (pericardial tamponade): Causes, symptoms, and treatment

Cardiac tamponade (pericardial tamponade) is a serious medical condition in which blood or fluid fills the space between the heart and the sac surrounding it. This is associated with extreme pressure placed on the heart, preventing the ventricles from expanding fully, which means your heart cannot function properly. As a result, the heart cannot pump sufficient blood supply to the rest of the body which can lead to organ failure, shock, or even death.

A patient with cardiac tamponade must be treated immediately as it is a medical emergency. Once the symptoms are experienced, medical intervention must take place right away.

Cardiac tamponade causes and complications

Cardiac tamponade results from penetration of the pericardium, the thin sac surrounding the heart. This cavity can fill with blood or fluids, thus compressing the heart. As it fills, the pressure on the heart increases, and less blood can enter the heart – which means, less oxygenated blood is flowing to the rest of the body.

Causes of penetration of the pericardium include:

• gunshot or stab wounds
• blunt trauma to the chest from a car or industrial accident
• accidental perforation after cardiac catheterization, angiography, or insertion of a pacemaker
• punctures made during placement of a central line, which is a type of catheter that administers fluids or medications
• cancer that has spread to the pericardial sac, such as breast or lung cancer
• a ruptured aortic aneurysm
• pericarditis, an inflammation of the pericardium
• lupus, an inflammatory disease in which the immune system mistakenly attacks healthy tissues
• high levels of radiation to the chest
• hypothyroidism, which increases the risk for heart disease
• a heart attack
• kidney failure
• infections that affect the heart

Complications resulting from cardiac tamponade include heart failure, pulmonary edema, bleeding, shock, and death.

Symptoms of cardiac tamponade

Symptoms of cardiac tamponade include anxiety, restlessness, sharp chest pain also experienced in the neck, shoulders or abdomen, breathing problems, discomfort, fainting, lightheadedness, pale, grey, or bluish skin, heart palpitations, rapid breathing, swelling of the legs or abdomen, jaundice, drowsiness, or a weak or faint pulse.

Diagnosing cardiac tamponade

There are three main signs your doctor will look for in order to properly diagnose cardiac tamponade. These are low blood pressure or weak pulse, extended neck veins, and a rapid heartbeat combined with a muffled heart sound.

To better diagnose cardiac tamponade, your doctor will complete other tests as well, such as an echocardiogram, chest X-ray, a thoracic CT scan, magnetic resonance angiogram, and an electrocardiogram. These tests allow your doctor to see what is going on with your heart and measure your heartbeat.

Cardiac tamponade treatment and home remedies

As mentioned, cardiac tamponade is a medical emergency that requires immediate hospitalization. Cardiac tamponade treatment aims to relieve the pressure around the heart and treat the underlying condition that caused cardiac tamponade in the first place. The initial target of the treatment, though, is to stabilize the patient.

The doctor at first will drain the built-up fluid around the heart, commonly done with a needle. To remove blood or blood clots, they may perform a more invasive procedure known as thoracotomy. A part of the pericardium may be removed in order to relieve pressure.

The patient is put on oxygen and administered fluids and medications to treat blood pressure.

Once the patient is stabilized, additional tests may be conducted to determine the underlying cause.

After you have been medically treated for cardiac tamponade, there are some considerations to keep in mind while you recover at home. For starters, ensure the affected area is well cleaned post-surgery with lukewarm water and soap, but avoid applying pressure to clean the area. Avoid vigorous activities, especially those that burden the chest. If there are any signs of infection or pain and if swelling persists, contact your doctor immediately. Reduce your salt intake to avoid fluid retention. Avoid eating oily foods, smoking, and drinking alcohol, and make sure to discuss your blood thinning medication with your doctor, as these factors can worsen prognosis. Lastly, adhere to any recommendations your doctor has suggested for home care and rehabilitation.