Cardiac tamponade is a dangerous condition brought about by excess fluid around the heart. The buildup of fluid in the pericardial sac places pressure on the heart and prevents it from fully relaxing between heartbeats.
The pressure prevents the heart from completely filling with blood before the next heartbeat. This reduces the amount of blood being driven by the heart. If the pericardial fluid pressure is high enough, it can lead to a drop in the blood pressure, erratic heart rhythms, shock and even death.
What is the cause?
There are various conditions that can lead to cardiac tamponade:
The abrupt bleeding to the heart sac can be brought about by:
- Damage to the heart sac
- Tear in the heart muscle during or after a heart attack
- Rupture in the aorta
The steady accumulation of fluid around the heart can be caused by:
- Cancer in or close to the heart
- Inflammation or infection of the heart sac
- Kidney failure
What are the indications?
The indications of cardiac tamponade are generally mild and includes:
- Low blood pressure
- Shortness of breath
- Fainting spells
- Rapid heart rate
- Engorged arm or neck veins
- Weakness and feeling sick
Management of cardiac tamponade
A severe case of cardiac tamponade is promptly treated since it can lead to death. Some or all the pericardial fluid should be removed using a needle or surgery.
- If a needle is utilized, a site in the chest is numbed with an anesthetic. The needle is inserted via the chest wall over the heart or area right beneath the breastbone. The needle pierces the pericardial sac around the heart. Once a puncture is made, a tube is inserted to drain the fluid.
- If surgery is performed, general anesthesia is given. An incision in the chest is created and the pericardial sac is opened to drain some of the fluid. In some cases, a small region in the pericardium is removed. A drain might be left in place for several days to prevent fluid buildup.
The symptoms typically settle once the fluid is removed. The drainage tube is generally left in place for 1-2 days and then removed.