CARDIAC TAMPONADE: A FATAL CONDITION THAT MOST DON’T KNOW ABOUT
Dr. Mohan Kumar HN, Consultant – Interventional Cardiologist, Columbia Asia Hospital Sarjapur Road
We all know that our heart is the most significant yet the most sensitive organ of our body. It goes without saying that our heart hence requires special attention and care. Reasons, both external as well as internal can affect our heart. While the lifestyle being lived these days has thrown enough light on the concerns related to heart like cardiac arrest, heart failure, heart attack, etc. There still remains one very serious medical condition that is not a result of the lifestyle choices really but is something grave enough to be known about. The condition being referred to here is called cardiac tamponade. To put it simply, it is the compression of the heart due to a fluid being collected in the sac that surrounds the heart. This thin, double-walled sac around the heart is called pericardium.
How it occurs?
There is a sac that encloses the heart and the heart muscle. When the space between that sac (pericardium) gets filled with blood or fluids, it results in cardiac tamponade which is a serious medical condition. The filling with the fluid creates a lot of pressure on the heart and the pressure in turn, does not allow the ventricles of the heart to expand completely and hence does not let the heart function properly.
The cavity around the heart can fill with bodily fluids or blood enough to compress the heart. As the fluid presses on the heart, it becomes more and more difficult for the blood to enter the heart. Naturally, the amount of blood reaching the heart reduces.
As a result, less oxygen-rich blood gets pumped to the rest of the body or the heart is unable to pump blood adequately to the rest of the body which can eventually result in organ failure, shock, and cardiac arrest or can even be fatal.
Some of the causes that can create such a situation are:
- It is generally the result of penetration of the pericardium that causes cardiac tamponade. Some of the causes of pericardial penetration or fluid accumulation can be:
- Wounds from a stab or gunshot
- Explicit trauma to the chest due to a car or industrial accident
- Perforation that can happen accidentally after cardiac catheterization, angiography, or insertion of a pacemaker
- Punctures made during placement of a central line
- Breast or lung cancer that might spread to the pericardial sac
- A ruptured aortic aneurysm
- Pericarditis, an inflammation disease in which the immune system by mistake attacks healthy tissues
- Chest extremely exposed to radiation
- Heart attack
- Kidney failure
- Other infections that are likely to affect the heart
Since cardiac tamponade is a serious medical condition that can even be fatal, it is important to watch out for the likely symptoms some of which include:
- Restlessness and anxiety
- Low blood pressure
- Chest pain radiating to your neck, shoulders, or back
- Difficulty in breathing or taking deep breaths
- Fast breathing
- Discomfort that’s relieved by sitting or leaning forward
- Dizziness and loss of consciousness
Once you observe any of the symptoms, you should seek medical help at the earliest. The diagnosis of cardiac tamponade usually consists of three signs that a doctor recognizes, which are also called as Beck’s triad. These signs include:
- Low blood pressure and weak pulse as the volume of the blood being pumped by the heart gets reduced.
- Extended neck veins due to the difficulty they experience in returning blood to the heart.
- A rapid heartbeat along with muffled heart sounds because of the increasing layer of fluid inside the pericardium.
Some other diagnostic tests like an echocardiogram, a thoracic CT scan, a magnetic resonance imaging are also done after the above observations to confirm a cardiac tamponade.
However, once diagnosed, cardiac tamponade needs hospital immediate hospitalization and emergency invasive treatment to relieve pressure on the heart before treating the underlying condition. The patient needs to be stabilized too before the procedures are undertaken.