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Tamponade is a pathological condition that occurs within the heart muscle. It consists in filling the pericardial cavity with a fluid that has the character of an exudate or exudate. This situation is a significant impediment to the process of filling the atria and heart chambers with blood. Tamponade may arise as a consequence of a heart attack and lead to cardiogenic shock, during which the so-called minute volume of the heart. What are the symptoms of cardiac tamponade? How to recognize it?
Cardiac tamponade – how does it happen?
The pericardium is a membrane that consists of two layers – serous and fibrous. The latter is on the outside, it protects the heart. The fluid contained here absorbs shocks and also protects this organ. As mentioned, cardiac tamponade occurs when the pericardial sac surrounding this organ fills with blood. This, in turn, causes difficulties in filling the heart cavities – atria and ventricles, a sharp drop in blood pressure and acceleration of the heart muscle. Cardiogenic shock also causes a decrease in cardiac output. Difficulties in proper filling of the atria and ventricles may also cause venous stasis in the peripheral vessels and lungs. As much as 2000 ml of fluid can build up during a cardiac tamponade.
Cardiac tamponade – causes
There can be many causes of cardiac tamponade. One of the most common causes is a rupture of the heart wall following a heart attack or an aortic aneurysm. However, cardiac tamponade can also occur as a result of trauma, such as a stab wound, which is usually very deep and capable of damaging the blood pump. Complicated cardiac surgery may also be the cause of cardiac tamponade. However, these are the so-called acute cases. Cardiac tamponade may very well develop slowly and need not be related to the above-mentioned situations. It occurs most often during pericardial metastases, pericarditis or liver failure.
Cardiac tamponade – symptoms
Typical symptoms of cardiac tamponade include: increased heart rate due to increased heart rate, dry paroxysmal cough with shortness of breath increasing when lying down, rather nonspecific chest pain, feeling cold and pale skin. Among the medical tests that will allow for accurate diagnosis of cardiac tamponade, electrocardiography (ECG) can be mentioned, which may be normal if tamponade is suspected, but also tachycardia, i.e. an acceleration of the heart rate above 100 beats per minute. Cardiac tamponade can also be identified by tests such as echocardiography, in which a specialist can see excess fluid in the pericardium, and chest X-rays, in which there is a noticeable enlargement of the heart muscle. The conducted research allows to detect the so-called Beck’s triad of symptoms. It consists of: a sharp drop in blood pressure, dilation of the neck vessels and hardly audible heart tones.
Cardiac tamponade – what does first aid look like?
Only a doctor can help in the event of cardiac tamponade. This condition must be treated by removing excess fluid from the pericardial sac. The entire procedure, called pericardiocentesis, is carried out with the use of an ultrasound scanner, which allows obtaining an accurate picture of the course of treatment. The specialist uses a specialized needle to remove excess fluid. If paericardiocentesis is not sufficient, cardiac tamponade is treated with surgery. This surgical procedure is then called a pericardiectomy, which can be either a partial surgery to remove a small amount of the pericardial sac, or a radical surgery that removes the entire pericardium. Occasionally, recurrent tamponade is also found, which is most often seen in those patients who have severely injured the chest. As a result of vascular damage, blood and fluid begin to fill the pericardial sac, making it difficult for blood to flow into the heart cavities and may cause cardiogenic shock. In order to prevent recurrence of tamponade, the so-called pericardial drainage. Failure to get help in time may result in cardiac arrest and death. Due to the rapidly progressive heart failure and the associated increasing risk of cardiogenic shock, cardiac tamponade has a high mortality rate.