Clinical Examination of the Cardiovascular System

12 Scary Symptoms of Cardiac Tamponade

Dr Aadarsh Yadav5th December 2019

Introduction

Cardiac tamponade is defined as the rapid accumulation of fluid or blood in the pericardial space, causing an increase in the intra-pericardial pressure. It is one of the serious medical condition which required immediate medical attention.

Patients with cardiac tamponade are also known as pericardial tamponade. The fluid is accumulated in the pericardium, which consists of two thin layers of tissue. This area usually contains a petite amount of fluid to prevent friction between the layers.

In this article, we altercate the symptoms of cardiac tamponade and also the risk of this pathology.

Key point

• It is most often caused by penetrating wound medial to nipples (for anterior injuries) or the scapulae (for posterior wounds).
• The triad of muffled heart tones, hypotension, and neck vein distention is diagnostic but not consistently present; in their absence, bedside echocardiography should be done if the diagnosis is suspected.
• Subxiphoidal pericardiocentesis is a temporizing measure and maybe be falsely negative; a pericardial window or pericardiotomy is more definitive.

Symptoms of cardiac tamponade

Patients suffering from cardiac tamponade feature the following symptoms:

1. Anxiety and restlessness
2. Low blood pressure (hypotension)
3. Chest pain radiating to your neck, shoulder, or back
4. Difficulty in breathing
5. cough
6. Rapid breathing
7. Bulging veins in neck, head, or temples
8. Discomforts that are relieved by sitting or leaning forward
9. Fainting and dizziness
10. Nausea or abdominal pain
11. Swelling of leg or abdomen
12. Loss of consciousness

Physical indisposition with cardiac tamponade may be very non-specific. These may include chest pain, cough, difficulty in breathing (dyspnea) and rapid breathing. The classic triad of physical signs is hypotension (low blood pressure), distension of the jugular veins of the neck, and quiet or muffled heart sounds.

The types and grimness of cardiac tamponade symptoms depend on whether the disease has developed acutely or gradually. Acute tamponade is most consistently produced by chest trauma, cardiac surgery or other invasive cardiac procedure, mansion such as cardiac catheterization, or by aortic dissection.

In all this condition, blood can fill the pericardial space in a matter of seconds or minutes, generating a rapid and severe cardiac compromise. Because the nimiety fluid (that is, blood) in the pericardial space accumulates rapidly in these conditions, it can establish even with a relatively small amount of pericardial fluid. Symptoms of cardiac tamponade are immediately striking and severe.

Chest pain, severe shortness of breath, and tachycardia and palpitations are common. Shallow blood pressure may occur, along with abnormally cold skin, bluish skin discoloration, and reduced output of urine.

Symptoms of cardiac tamponade in sub-acute tamponade are dramatic. Patients with subacute tamponade generally encounter chest fullness or discomfort, natural fatigue ability, shortness of breath with minimal activity, and edema in the legs and feet. But while symptoms of subacute cardiac tamponade develop less hysterically than with acute tamponade, they can eventually become quite astringent.

This more progressive form of the disease can also become baleful, and expeditious treatment is still necessary.

Why is acute cardiac tamponade is a surgical emergency?

Cardiac tamponade usually results from bleeding into the pericardium, a sac that surrounds the heart. The pericardium is made of muscular tissue. As the pressure in the pericardium aggrandizes, It can reach enough pressure to prevent the heart from expanding when it needs to. (the heart needs to grow to allow its chamber to fill with blood) The situation will cause death quickly. That’s why acute it is known as a surgical emergency.

Increased JVP in cardiac tamponade

In cardiac tamponade, the heart is choked, and blood will pool behind, this will raise JVP leads to exp of the neck veins, so this is also called jugular venous distention (JVD).

Note: JVP changes are the most precarious sign in cardiac tamponade.

Decreased blood pressure (Hypotension)

As the heart is strangulated, the ventricular filling is reduced, leading to less end-diastolic volume (low-end diastolic pressure). This condition causes a decrease in the stretch and contraction in the myocardium, stroke volume, cardiac output, leading towards a reduction of systolic blood pressure.

Due to low blood pressure, the patient may have a clinical demonstration of shock, i.e. cold and clammy hand.

Development of Tachycardia (increased pulse rate)

When blood pressure abate, sympathetic overflow occurs, and tachycardia is developed.

When there is no tachycardia, there is no cardiac tamponade, excluding in these conditions:

• Patient of cardiac tamponade, who have pericardial effusion as an aftereffect of myxedema due to hypothyroidism.
• Uremia, because uremia produces bradycardia and heart blocks.
• The patient is taking beta-blockers.
• The patient at the terminal stage.

What increases the risk of cardiac tamponade?

• Infection or inflammation
• Hypothyroidism
• Lymphoma, breast cancer, or lung cancer
• Recent heart or abdominal surgery
• Recent heart attack
• Kidney failure

Can you die from cardiac tamponade?

Yes, this is a climacteric situation where fluid, blood plasma, etc. is trapped between and around the heart and the pericardial sac, which reduces the volume of blood the heart can pump out, thereby decreasing cardiac output, lowering blood pressure and flow to your body. Depending on the rate and amount of accumulation, you became very critical and can die from circulatory failure.

Conclusion

Cardiac tamponade is an emergency medical condition that requires immediate hospitalization. The onset of the disease may be rapid (acute), or more gradual (subacute). Symptoms of cardiac tamponade typically include chest pain, hypotension, tachypnea, tachycardia and many more which you have read in principle article. However, some of these symptoms of cardiac tamponade may not be present in a particular case. I hope you can learn about 12 scary symptoms of cardiac tamponade. If you have any queries, feel free to comment below in the comment box.