Cardiac Tamponade - Introduction

Cardiac tamponade is a clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise. Cardiac tamponade is a medical emergency. The overall risk of death depends on the speed of diagnosis, the treatment provided, and the underlying cause of the tamponade.

Incidence Frequency: The incidence of cardiac tamponade is 2 cases per 10,000 population in the United States. Approximately 2% of penetrating injuries are reported to result in cardiac tamponade.

Mortality/Morbidity: Cardiac tamponade is a medical emergency. Early diagnosis and treatment are crucial to reduce morbidity and mortality. Untreated, it is rapidly and universally fatal.

Sex: In children, cardiac tamponade is more common in boys than in girls, 7:3. In adults, cardiac tamponade appears to be slightly more common in men than in women. 1.25:1

Age: Cardiac tamponade related to trauma or HIV is more common in young adults, whereas tamponade due to malignancy and/or renal failure occurs more frequently in elderly individuals

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Causes

For all patients, malignant diseases are the most common cause of pericardial tamponade. Tamponade can occur as a result of any type of pericarditis.

• HIV infection

• Infection - Viral, bacterial (tuberculosis), fungal

• Drugs - Hydralazine, procainamide, isoniazid, minoxidil

• Postcoronary intervention (ie, coronary dissection and perforation)

• Trauma

• Cardiovascular surgery (postoperative pericarditis)

• Postmyocardial infarction (free wall ventricular rupture, Dressler syndrome)

• Connective tissue diseases - Systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis

• Radiation therapy

• Iatrogenic - After sternal biopsy, transvenous pacemaker lead implantation, pericardiocentesis, or central line insertion

• Uremia

• Idiopathic pericarditis

• Complication of surgery at the esophagogastric junction such as antireflux surgery

• Pneumopericardium (due to mechanical ventilation or gastropericardial fistula)

Other Problems to be considered:

Large pleural effusion
Tension pneumopericardium

Rapid and labored breathing

Category: Medicine Notes