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Chapters

0:00 Introduction
0:33 Causes of Pericardial Tamponade
1:13 Signs and symptoms of Pericardial Tamponade
1:39 Diagnosis of Pericardial Tamponade
2:41 Treatment for Pericardial Tamponade

Cardiac tamponade, also known as pericardial tamponade (/ˌtæm.pəˈneɪd/[4]), is the buildup of fluid in the pericardium (the sac around the heart), resulting in compression of the heart.[2] Onset may be rapid or gradual.[2] Symptoms typically include those of obstructive shock including shortness of breath, weakness, lightheadedness, and cough.[1] Other symptoms may relate to the underlying cause.[1]

Common causes of cardiac tamponade include cancer, kidney failure, chest trauma, myocardial infarction, and pericarditis.[2][5] Other causes include connective tissues diseases, hypothyroidism, aortic rupture, autoimmune disease, and complications of cardiac surgery.[2][6] In Africa, tuberculosis is a relatively common cause.[1]

Diagnosis may be suspected based on low blood pressure, jugular venous distension, or quiet heart sounds (together known as Beck's triad).[2][1][7] A pericardial rub may be present in cases due to inflammation.[2] The diagnosis may be further supported by specific electrocardiogram (ECG) changes, chest X-ray, or an ultrasound of the heart.[2] If fluid increases slowly the pericardial sac can expand to contain more than 2 liters; however, if the increase is rapid, as little as 200 mL can result in tamponade.[2]

Tamponade is a medical emergency.[5] When it results in symptoms, drainage is necessary.[8] This can be done by pericardiocentesis, surgery to create a pericardial window, or a pericardiectomy.[2] Drainage may also be necessary to rule out infection or cancer.[8] Other treatments may include the use of dobutamine or in those with low blood volume, intravenous fluids.[1] Those with few symptoms and no worrisome features can often be closely followed.[2] The frequency of tamponade is unclear.[9] One estimate from the United States places it at 2 per 10,000 per year.[3]