Discussion Author(s): Primary author: Jason Messinger
Contributing author: Eric Jones
Cardiac tamponade can be a fatal condition and occurs when fluid gets into the pericardial space and compresses the heart. It is defined as a â€śdecompensated phase of cardiac compression resulting from an increase in intrapericardial pressure. One study has reported that IVC niveau sign is an effective in differentiating acute cardiac tamponade from chronic pericardial effusion.
The condition can be visualized using radiographs such as CT, MRI, chest X-ray, coronary angiography, and other techniques like electrocardiogram. Diagnosis of the condition is made after considering clinical history, physical examination, and imaging. Studies have suggested that a low voltage QRS finding is one possible indication of cardiac tamponade. On CT imaging, cardiac tamponade is associated with â€śdistension of large systemic veins, periportal edema, compression of the coronary sinus, azygos reflex sign, and flattened heart sign.â€ť Symptoms of cardiac tamponade can vary and include anxiety, dyspnea, cyanosis, tachypnea, and swelling of the abdomen.
Among the most common etiologies for cardiac tamponade include dissecting aortic aneurysm, end-stage lung cancer, acute myocardial infarction, heart surgery, pericardial effusion, radiation pericarditis, and trauma to the heart. The incidence for cardiac tamponade is about 2 in 10,000.
Cardiac tamponade is considered an emergency condition that must be treated as soon as possible. Course of treatment for patient with cardiac tamponade depends on the etiology of the condition. Pericardiocentesis is regularly preformed to drain fluid in the pericardial space to relieve the compression of the heart. In cases of pleural effusion, thoracotomy can be done in a procedure that allows communication between the pericardium and pleural space, thus allowing drainage of both regions simultaneously. Above all, it is imperative that treatment be started as quickly as possible given the possibility of death.
Percutaneous pericardial drainage is a new, quick, and safe way to resolve cardiac tamponade
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