Cardiac tamponade is a condition where fluid, blood, pus or clots accumulate in the pericardial space surrounding the heart, compressing the heart and reducing cardiac output. It can occur when the pericardial sac contains over 100ml of fluid rapidly or over 1 liter slowly. Causes include aortic aneurysm, heart attack, cancer, infections, trauma and other conditions. Symptoms include anxiety, shortness of breath, fast heart rate and pulse pressure changes. Diagnosis is made through echocardiogram, chest x-ray and ECG. Treatment involves draining fluid via pericardiocentesis or surgery as well as medications and fluids to support blood pressure.

2. What is cardiac tamponade?
Type of pericardial
effusion in which
blood(most
common), fluid, pus,
clots, or gas
accumulates in the
pericardial space,
resulting in
compression of the
heart and decreased
cardiac output as a
result.

3. Pericardium typically has 20-50ml of
fluid.
If fluid increases slowly, pericardial sac
can expand up to contain a litre or
more, but if fluid effusion occurs
rapidly as little as 100ml can cause
tamponade.

4. Causes:
 Aortic aneurysm
 heart attack,
 Post heart surgery(chest tubes used for drainage are
prone to clot formation and blood that should be
drained accumulates around the heart)
 penetrating and blunt wounds (chest trauma)
 Cancer
 hypothyroidism
 Uremia
 idiopathic pericarditis
 infectious disease(viral or bacterial)
 anticoagulation,
 connective tissue diseases(SLE and rheumatoid
arthritis).
 Dressler's syndrome
 can occur as a result of any type of pericarditis.

6. OTHER IMPORTANT
SYMPTOMS:
Anxiety
Dyspnea
Tachycardia
tachypnea

7. pulsus paradoxus: decrease in
systemic blood pressure by 10-
12mmhg during inspiration and
can be accompanied by
increase in jugular venous
pressure (kussmaul’s sign).
maybe cyanosis
cold and clammy extremities
from hypoperfusion.

8. musculoskeletal pain
Fever
dysphoria

9. orestless body
movements
ounusual facial
expressions,
orestlessness,
oforced
position:
sitting or
leaning
forward.

10. Complications:
Heart failure
Pulmonary edema
Shock
death

11. Differential diagnosis:
aortic dissection,
pulmonary embolism
Tension pneumothorax
pleural effusion

12. Diagnosis:
chest x-ray: cardiomegaly, water bottle shaped
heart, pericardial calcifications, evidence of
trauma. MRI, ECG

13. Echocardiogram:

14. Treatment:
 Oxygen
 volume expansion with blood, plasma,
or isotonic sodium chloride solution, as
necessary, to maintain adequate
intravascular volume
 Bed rest with leg elevation - This may
help increase venous return
 Inotropic drugs (e.g., dobutamine)
 removal of pericardial fluid by
pericardiocentesis or pericardiotomy

15. Epidemiology:
 more in males than in females
 tamponade related to trauma or HIV is more
common in young adults.
 tamponade due to malignancy or chronic
renal failure is more common in elderly
individuals.
 Mortality rate: 4%
 Complication rate: 17%
 mortality rate depends on the speed of diagno
sis and treatment
 if untreated the condition is rapidly and univer
sally fatal