What does cardiac tamponade stand for?

If the doctor speaks of cardiac tamponade, the circumstance has occurred that so much fluid has accumulated in the pericardium that the heart function is impaired. The heart muscle is constricted from the outside. Such accumulations of fluid can be triggered by inflammation; the fluid may be clear, but it may also contain pus or blood.

What is cardiac tamponade?

According to DigoPaul, cardiac tamponade (medical: pericardial tamponade ) is a complication that occurs as a result of fluid accumulation in the pericardium. This leads to the so-called pericardial effusion; Rarely, accumulations of air can also be the reason for a complication, whereby the doctor speaks of a pneumopericardium.

Even small amounts of fluid can impede ventricular filling and reduce stroke volume to such an extent that the patient’s life is at risk. As a further consequence, there is reduced blood flow in the coronary arteries – this circumstance leads to insufficient oxygen supply ( hypoxia ).

As the disease progresses, cardiac insufficiency (cardiac insufficiency) occurs. The fluid can be blood (hemopericardium), pus (pyopericard) or a serous fluid (hydropericardium) or a chyle (chylopericardium). The accumulation of fluid creates pressure, which constricts and compresses the heart and impairs its function.

Causes

Cardiac tamponade is usually triggered by a rupture of the pericardium. The pericardium is a thin sac that surrounds the heart. The cavity around the heart fills with blood or other fluid, compressing the heart.

If the fluid presses on the heart, less and less blood gets into the heart, resulting in an undersupply of blood. Shock occurs, followed by organ failure and finally cardiac arrest. Possible causes that can trigger cardiac tamponade include gunshot or stab wounds.

Conceivable causes are also trauma as a result of a work or traffic accident, an attack of the pericardium with lung cancer, breast cancer or other types of cancer. Inflammation of the sac around the heart (pericarditis), doses of radiation to the chest, hypothyroidism, and chest tubes used after heart surgery can also cause cardiac tamponade.

Symptoms, Ailments & Signs

If cardiac tamponade occurs, the affected person complains of the following symptoms: The patient suffers from states of anxiety and restlessness; blood pressure is very low. Sometimes the patient feels weak, complains of chest pain, which can also radiate to the neck, back or shoulders.

Sometimes breathing difficulties become noticeable and also problems taking deep breaths. Those affected suffer from accelerated breathing, may faint and become unconscious, or complain of persistent dizziness.

Diagnosis & History

A cardiac tamponade is usually noticeable by three signs, which the doctor determines during the physical examination. This is the so-called Beck’s triad, which has the following characteristics: low blood pressure and very weak pulse, with a reduced amount of blood; enlarged veins in the neck and an accelerated heartbeat.

If there is a suspicion that it is cardiac tamponade, further tests are carried out so that the doctor can confirm his suspicion. First follows an echocardiogram (heart ultrasound); During this examination, the doctor can determine whether the pericardial sac has already expanded. Sometimes he can also determine whether the heart valves – due to the insufficient amount of blood – have collapsed.

If the doctor has X-rays of the thorax made, he can sometimes also see an enlarged heart; this circumstance also speaks for a cardiac tamponade. Other tests include thoracic computed tomography (CT), in which the doctor can determine whether there have been heart changes or fluid accumulations.

Using magnetic resonance imaging (MRI), it is possible to recognize the structure of the heart. With a coronary angiography, the doctor can check the blood flow; the electrocardiogram is used to check the heartbeat. The chance of survival depends on the time of diagnosis. Sometimes the cause also plays an important role.

If the cardiac tamponade is detected relatively quickly and then treated immediately, the prognosis is good. However, if the doctor cannot drain the fluid from the pericardium in time, there is a shock and, as a result, organ failure. Sometimes these circumstances can lead to the death of the patient.

Complications

Cardiac tamponade causes heart problems, which in the worst case can be fatal for the patient. As a rule, the function of the heart is severely impaired by the disease. This leads to a drop in blood pressure and anxiety and reduced resilience.

It is not uncommon for patients to also suffer from chest pain and shortness of breath, so that cardiac tamponade can be mistaken for a heart attack. Difficulty breathing often leads to panic attacks or sweating. The low blood pressure can cause a loss of consciousness or dizziness. Losing consciousness can potentially injure the patient if a fall occurs.

The quality of life of those affected is extremely limited and reduced by the cardiac tamponade. Due to the weak pulse, it is usually only possible to carry out various activities to a limited extent. If the cardiac tamponade is not treated in time, the patient dies. As a rule, there are no special complications during treatment. However, a causal treatment of the disease is then also necessary in order to eliminate the trigger for the cardiac tamponade.

When should you go to the doctor?

If physical symptoms such as difficulty breathing, impaired consciousness and dizziness are noticed, cardiac tamponade may be present. Other warning signs of heart disease include restlessness, low blood pressure, and chest pain that can radiate to the neck, back, and shoulders.

If these symptoms are noticed, a doctor must be consulted. This applies in particular to persistent symptoms that increase in intensity over time or significantly impair well-being.

In the event of shock or heart failure, an ambulance must be called. First aid must be given to the victim until medical assistance arrives. Cardiac tamponade particularly affects lung cancer or breast cancer patients, people with pericarditis, and accident victims. There is also an increased risk of developing cardiac tamponade after heart surgery or radiation treatment.

Corresponding risk patients should take the symptoms mentioned particularly seriously and preferably speak to their family doctor immediately. He can clarify the symptoms and, if necessary, refer the patient to a cardiologist or a specialist in internal medicine.

Treatment & Therapy

The cardiac tamponade represents a medical emergency. The patient is treated as an inpatient. The treatment takes place in two steps: At the beginning, the doctor tries to take the pressure off the heart. If the heart is relieved, the disease that caused the cardiac tamponade is treated. It is important that the patient is stable.

The doctor places a drain that ensures that the fluid is sucked out of the pericardium. Sometimes the pericardium can also be partially removed if too little fluid is suctioned out; the partial removal also provides relief for the heart. The patient is additionally supplied with oxygen, receives medication and fluids that increase blood pressure.

Once the doctor has the cardiac tamponade under control and the patient stabilized, further tests can be performed. The doctor tries to identify the cause of the cardiac tamponade and then to treat the causative disease.

Outlook & Forecast

Without medical care for the patient, the prognosis of cardiac tamponade is unfavorable. The functional activity of the heart is restricted by the loads. As the disease progresses, organ failure occurs and the patient dies prematurely.

With timely and adequate medical treatment, the survival of the patient can be ensured. The liquid is drained in a professional intervention. In some cases, part of the pericardium is removed. This relieves the pericardium and heart activity normalizes.

Nevertheless, the quality of life of those affected by cardiac tamponade is also limited in the long term, as there is reduced physical performance. If the doctor treating you succeeds in adequately regulating the blood flow, the prognosis improves significantly.

Nevertheless, monitoring of heart activity is necessary throughout life in order to be able to react immediately to changes or abnormalities. The cause of the cardiac tamponade must be found and corrected so that the patient’s overall health can be optimized.

If this is not successful, the fluid will accumulate again in the pericardial sac. Complete recovery or healing can only be expected in very rare cases. Usually there is a chronic disease that leads to a triggering of fluid accumulation.

Prevention

Cardiac tamponade cannot usually be prevented. If there are signs that indicate a cardiac tamponade, a doctor should be contacted immediately – there is an acute danger to life.

Aftercare

In the case of a cardiac tamponade, in most cases those affected only have a few measures and options for aftercare. Rapid diagnosis is crucial so that the heart can be treated properly. Further complications and symptoms can only be prevented by early diagnosis and subsequent treatment.

In the case of a cardiac tamponade, the focus is therefore on early detection, so that a doctor should be consulted as soon as the first signs of this disease appear. In most cases, cardiac tamponade is treated by surgery. The person concerned should rest and rest after this procedure in any case. Stressful or physical activities should be avoided in order not to put unnecessary strain on the heart.

It is usually necessary to take medication to support the treatment. It is important to ensure correct intake and dosage. If you have any questions or are unclear, you must consult your doctor. The doctor should also be consulted if side effects or interactions occur. In some cases, cardiac tamponade also reduces the life expectancy of those affected.

You can do that yourself

As a rule, cardiac tamponade cannot be treated by self-help. Interventions by a doctor and the taking of medication are necessary to combat the symptoms and complaints.

If an affected person suffers from a cardiac tamponade and possibly loses consciousness, an emergency doctor must be called immediately. The person concerned can be treated with first aid measures until the emergency doctor arrives. Furthermore, the person concerned must also be in a stable lateral position.

Patients suffering from cardiac tamponade must not exert their bodies excessively and unnecessarily. In this way, many complaints can be avoided or alleviated. Calm and, above all, regular breathing also has a positive effect on the course of the disease.

In most cases, patients with this disease are dependent on a stay in a hospital. The support of friends and family can also significantly alleviate the psychological symptoms and contribute to the patient’s stability. In most cases, complications can be avoided with early treatment of the disease, so the life expectancy of the patient with cardiac tamponade is not reduced.

cardiac tamponade