Cardiac tamponade

Question 1

1) What is cardiac tamponade?
2) What is the difference between the terms pericardial effusion and cardiac tamponade?

Answer 1

1) Medical emergency where there’s excess fluid in the pericardial sac which compresses the heart leading to a decrease in CO and shock. Under the excess pressure, the chambers of the heart are unable to relax which reduces venous return, filling and consequently CO.
2) Pericardial effusion is the technical term for fluid accumulating in the pericardial sac, and cardiac tamponade is when the pressure from the fluid accumulation impairs heart function

Question 2

1) Name a cause of a rapid buildup of pericardial fluid
2) Name a cause of a slower buildup of pericardial fluid
3) Name 2 symptoms/signs of cardiac tamponade

Answer 2

1) Haemorrhage i.e. due to aortic dissection or a puncture wound to the heart
2) Infections i.e. TB, tumours, autoimmune diseases i.e. lupus
3) Anxiety and restlessness, low BP, weakness, chest pain radiating to neck, shoulders or back, trouble taking deep breaths, rapid breathing and fainting or dizziness

Question 3

1) Diagnosis is based on 3 clinical features called what?
2) What are these 3 clinical features?
3) What is pulsus paradoxus?
4) What is Kussmaul’s sign?
5) Name another diagnostic test and what might they be used to look for

Answer 3

1) Beck’s triad
2) Low BP and weak pulse, extended neck veins and a rapid heartbeat with muffled sounds
3) Pulse fades on inspiration
4) Increased JVP on inspiration
5) Echocardiogram – distention of the pericardium or ventricle collapse. Thoracic CT scan – fluid accumulation in the chest or changes to the heart. MRI angiogram – assess blood flow through the heart

Question 4

What is the procedure that’s used for the treatment of cardiac tamponade called?

Answer 4

Pericardiocentesis

Question 5

How is cardiac tamponade managed when the cause is malignant?

Answer 5

Percutaneous balloon pericardiotomy