What Is Cardiac Tamponade?
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Medically reviewed by Rafle Fernandez, MD
Cardiac tamponade is an urgent medical condition that occurs when fluid builds up around your heart, making it difficult for the heart to function properly. This buildup of fluid can occur rapidly due to conditions like traumatic injury, a rupture in the heart wall, certain infections, cancer, or some heart procedures.
The condition becomes an emergency when the fluid builds so much that the heart cannot do its job and pump blood effectively, leading to complications like shock and other life-threatening situations. That's why early detection and treatment are critical to prevent the risk of death with cardiac tamponade.
While this condition is rarer than other heart complications, certain people are at a higher risk of experiencing symptoms. People who live with HIV, advanced kidney disease, heart failure, tuberculosis, and autoimmune disorders like lupus are more likely to develop fluid buildup.
Cardiac Tamponade Symptoms
Recognizing the symptoms of cardiac tamponade can help you get medical care quickly. The hallmark symptoms of this condition are:
Rapid heartbeat
Swollen veins in the neck
Faint heart sounds and rhythms
Pulsus paradoxus, which occurs when your blood pressure decreases when you breathe in
It's also possible to experience a range of other symptoms, including:
Chest pain that worsens with deep breathing or coughing
Trouble breathing
Dizziness or fainting
Changes in skin color, like turning pale, gray, or blue
A weak or absent pulse
Swelling in the legs or abdomen
Jaundice, or the yellowing of your skin and eyes
Restlessness
Causes
Cardiac tamponade happens when fluid builds up in the sac around the heart. Rapid fluid buildup can occur through bleeding, such as from a serious heart injury or a rupture in the heart wall after a heart attack.
Other common causes, which generally lead to a slower buildup of fluid, include infections like tuberculosis, autoimmune disorders, cancer, kidney disease, and conditions that cause inflammation in your body, like pericarditis. It's also possible to develop this condition after undergoing heart-related medical procedures like an ablation or putting in a pacemaker.
Diagnosis
If you or a loved one are experiencing signs of cardiac tamponade, getting medical support quickly can save a life. Healthcare providers will look for cardiac tamponade by first doing a physical check-up. During this exam, they might find:
Blood pressure that drops while taking a deep breath
Fast breathing
A heart rate higher than 100 beats per minute (known as tachycardia)
Heart sounds that are very soft and difficult to hear with a stethoscope
Neck veins that look swollen
Weak or hard-to-find pulses in the arms and legs
To confirm if you have cardiac tamponade, your provider will likely order one or more imaging tests. A common example is an echocardiogram, which checks if there's fluid around the heart, how much there is, and if it's affecting your heart's function. A chest X-ray can also reveal if the heart looks enlarged and can detect fluid buildup around the heart. A CT scan of the chest may also detect fluid around the heart.
In some cases, you may need additional testing, such as a coronary angiography or a heart catheterization. Coronary angiography is a test where a special dye is used with X-rays to check how blood moves through the heart's arteries (blood vessels). A heart catheterization is a procedure that guides a thin tube or catheter through a blood vessel in the heart and shows how well your heart is working.
There are also certain blood tests that can help diagnose cardiac tamponade. These include testing your creatine kinase levels (an enzyme found in the heart, brain, and skeletal muscles), kidney function, and blood clotting status. Your provider may also order blood tests for conditions that increase the risk of cardiac tamponade, like HIV testing or a skin test for tuberculosis.
Cardiac Tamponade Treatment
The goals of treatment for cardiac tamponade are to reduce the risk of death, improve the heart’s function, and reduce the stress on the heart. When you start treatment, you'll first likely receive oxygen therapy, fluids that increase your blood volume, and bed rest that keeps your legs raised above your heart. Then, you'll receive the primary treatment for cardiac tamponade—a procedure called pericardiocentesis, which removes fluid from around the heart.
There are also surgical options that your provider can use, such as making a small opening in or removing part of the pericardium, the sac around the heart. In emergency situations, surgical treatment can be a life-saving measure.
It's worth noting that it's not usually possible to prevent cardiac tamponade. However, understanding the risk factors can help you get an early diagnosis and start treatment sooner. If you have a condition that increases your risk of cardiac tamponade, your provider can explain which symptoms to watch out for and offer ways to lower your risk of this complication.
Complications
Cardiac tamponade is a serious medical emergency that requires immediate attention. If it's not treated quickly, it can lead to several dangerous health problems, which may include:
Heart failure, where your heart can't pump blood effectively
Pulmonary edema, the buildup of fluid in the lungs that makes breathing difficult
Bleeding
Shock, which occurs when your body's tissues and organs don't get enough blood, leading to multiple organ failure
In serious cases, death
A Quick Review
Cardiac tamponade is a critical medical condition that occurs when fluid builds up around the heart, making it difficult to pump blood effectively. Conditions like heart attacks, chest trauma, infections, autoimmune diseases, and cancer can all increase the risk of experiencing symptoms. Common signs of cardiac tamponade include a rapid heartbeat, low blood pressure, and swelling in the neck veins. If you have symptoms, it's important to seek medical treatment urgently to prevent the risk of complications like shock or death.
Frequently Asked Questions
What is the difference between cardiac effusion and tamponade?
A pericardial effusion is when too much fluid builds up in the sac around the heart. Normally, this sac has about 15 to 50 milliliters of a special fluid to keep the heart lubricated. But the extra fluid in a pericardial effusion can lead to cardiac tamponade. Cardiac tamponade occurs when the fluid buildup puts so much pressure on the heart that it can’t function properly.
Are symptoms of cardiac tamponade and Beck's triad the same?
The symptoms of Beck's triad are low blood pressure, swollen neck veins, and faint or muffled heart sounds when a healthcare provider listens to the heart. Many people with cardiac tamponade experience Beck's triad alongside other symptoms like chest pain and trouble breathing.
How quickly does cardiac tamponade become fatal?
It depends on how rapidly the fluid around the heart builds up. If this buildup happens quickly, it can lead to a quick decline in heart function and death if the excess fluid or blood isn't removed in time. But when fluid buildup is lower, there might be more time for treatment and medical intervention.
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