Cardiac tamponade: what it is, causes and treatment

Cardiac tamponade is a medical emergency in which there is an accumulation of fluid between the two membranes of the pericardium, which are responsible for the lining of the heart, which causes difficulty in breathing, decreased blood pressure and increased heart rate, for example.

As a consequence of the accumulation of fluid, the heart is unable to pump enough blood to the organs and tissues, which can result in shock and death if it is not treated in time.

Causes of cardiac tamponade

Cardiac tamponade can happen to several situations that can result in the accumulation of fluid in the pericardial space. The main causes are:

• Trauma in the chest due to car accidents;
• History of cancer, especially of the lungs and heart;
• Hypothyroidism, which is characterized by a decrease in the production of hormones by the thyroid;
• Pericarditis, which is a disease of the heart that results from bacterial or viral infections;
• History of renal failure;
• Recent heart attack;
• Systemic lupus erythematosus;
• Radiotherapy treatment;
• Uremia, which corresponds to the elevation of urea in the blood;
• Recent heart surgery that causes damage to the pericardium.

The causes of tamponade must be identified and treated quickly so that cardiac complications are avoided.

How the diagnosis is made

The diagnosis of cardiac tamponade is made by the cardiologist through chest X-ray, magnetic resonance, electrocardiogram and transthoracic echocardiogram, which is an exam that allows to verify, in real time, the characteristics of the heart, such as size, muscle thickness and functioning of the heart, for example. Understand what the echocardiogram is and how it is done.

It is important to emphasize that as soon as the symptoms of cardiac tamponade appear, an echocardiogram should be performed as soon as possible, as it is the exam of choice to confirm the diagnosis in these cases.

Main symptoms

The main indicative symptoms of cardiac tamponade are:

• Blood pressure reduction;
• Increased respiratory and heart rate;
• Paradoxical pulse, in which the pulse disappears or decreases during inspiration;
• Dilatation of the veins in the neck;
• Chest pain;
• Fall in the level of consciousness;
• Cold, purple feet and hands;
• Lack of appetite;
• Difficulty swallowing:
• Cough;
• Difficulty breathing.

If symptoms of cardiac tamponade are perceived and are associated with symptoms of acute renal failure, for example, it is recommended to go immediately to the emergency room or the nearest hospital for tests and, in the case of confirmation of cardiac tamponade, initiated the treatment.

How is the treatment

Treatment for cardiac tamponade should be done as soon as possible by replacing the blood volume and resting the head, which should be slightly raised. In addition, it may be necessary to use analgesics, such as Morphine, and diuretics, such as Furosemide, for example, to stabilize the patient's condition until the liquid can be removed through surgery. Oxygen is also administered in order to reduce the load on the heart, reducing the need for blood by the organs.

Pericardiocentesis is a type of surgical procedure that aims to remove excess fluid from the heart, however it is considered a temporary procedure, but sufficient to relieve symptoms and save the patient's life. The definitive treatment is called the Pericardial Window, in which the pericardial fluid is drained into the pleural cavity that surrounds the lungs.

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