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.
(See also Introduction to Chest Injuries Introduction to Chest Injuries Chest injuries most often affect the ribs, upper part of the abdomen, lungs, blood vessels, heart, muscles, soft tissues, and breastbone. Sometimes the esophagus, collarbone, or shoulder blade... read more .)
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.
The most common causes are rupture of an aortic aneurysm Overview of Aortic Aneurysms and Aortic Dissection The aorta, which is about 1 inch (2.5 centimeters) in diameter, is the largest artery of the body. It receives oxygen-rich blood from the left ventricle and distributes it to all of the body... read more (a bulge in the wall of the aorta), advanced lung cancer Lung Cancer Lung cancer is the leading cause of cancer death in both men and women. About 85% of cases are related to cigarette smoking. One common symptom is a persistent cough or a change in the character... read more , acute pericarditis Acute Pericarditis Acute pericarditis is inflammation of the pericardium (the flexible two-layered sac that envelops the heart) that begins suddenly, is often painful, and causes fluid and blood components such... read more (inflammation of the pericardium), a heart attack Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or heart attack (myocardial infarction), depending on the location and amount... read more , and heart surgery.
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.
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
Prompt diagnosis and treatment are essential because cardiac tamponade can be rapidly fatal. The diagnosis is based on symptoms, examination results, and usually echocardiography Echocardiography and Other Ultrasound Procedures Ultrasonography uses high-frequency (ultrasound) waves bounced off internal structures to produce a moving image. It uses no x-rays. Ultrasonography of the heart (echocardiography) is one of... read more .
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).