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Cardiac Tamponade


Thomas G. Weiser

, MD, MPH, Stanford University School of Medicine

Last full review/revision Jun 2020| Content last modified Jun 2020
Topic Resources

Cardiac tamponade is pressure on the heart by blood or fluid that accumulates in the two-layered sac around the heart (pericardium). This disorder interferes with the heart's ability to pump blood.

  • People typically feel light-headed and short of breath, and they may faint.

  • The diagnosis is based on symptoms, examination results, and usually ultrasonography of the heart (echocardiography) done in the emergency department.

  • Blood is drained from around the heart using a needle and sometimes surgery.

In cardiac tamponade, fluid or blood accumulates between the two layers of the pericardium, which then tightly squeezes the heart. This pressure can prevent the heart from filling with blood. As a result, less blood is pumped to the body, sometimes causing shock Shock Shock is a life-threatening condition in which blood flow to the organs is low, decreasing delivery of oxygen and thus causing organ damage and sometimes death. Blood pressure is usually low... read more (with blood pressure becoming dangerously low) and death.

Chest injuries can also cause cardiac tamponade. The most common such injuries are stab wounds. Blunt injuries Blunt Injury to the Heart Blunt injury to the heart is a blow to the chest that bruises the heart muscle, tears (ruptures) the heart's walls, or damages a heart valve. People may feel that their heart is pounding or... read more that tear the wall of the heart can cause tamponade, but many people with such injuries die before they can be brought for medical treatment.

Cardiac Tamponade

Cardiac Tamponade

Symptoms of Cardiac Tamponade

People with cardiac tamponade may feel light-headed or short of breath. They may faint. They may have low blood pressure and a rapid heart rate. The skin may be cool, sweaty, and bluish. The veins in the neck may appear swollen or distended.

Diagnosis of Cardiac Tamponade

  • A doctor's evaluation

  • Echocardiography

Echocardiography (which uses ultrasound waves to produce an image of the heart) is usually done to confirm the diagnosis.

Treatment of Cardiac Tamponade

  • Removal of blood or fluid from around the heart

Cardiac tamponade is a medical emergency. Doctors treat it immediately by using a needle to remove the blood or fluid from around the heart (pericardiocentesis). This procedure relieves pressure on the heart and enables it to beat normally.

Sometimes pericardiocentesis fails to remove enough fluid. Then, doctors must make an incision into the chest wall (thoracotomy) and then the pericardium (pericardiotomy) to drain the fluid. They may also need to remove part of the pericardium (pericardiectomy).

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