What is cardiac tamponade?
Cardiac tamponade is a health problem affecting the heart. Blood or fluid collects in the pericardium (the sac that surrounds the heart). The blood or fluid puts extra pressure on the heart. This pressure keeps the ventricles of the heart from expanding fully, making the heart not able to work the right way. Because the heart is not able to pump fully, the body and vital organs do not get enough blood and oxygen.
Cardiac tamponade can be caused by many issues, such as:
- Dissecting aortic aneurysm.
- Metastatic cancer (cancer that has spread).
- Heart attack.
- Trauma to the heart such as surgery and pericarditis (inflammation of the pericardium caused by infections).
- Heart tumors.
- Placement of central lines.
- Radiation therapy to the chest.
Signs and symptoms of cardiac tamponade include:
- Feeling restless.
- Sharp chest pain or chest pain that gets worse with deep breathing.
- Trouble breathing.
- Change in color of the skin (pale, bluish, or gray).
- Heart palpitations (feeling like your heart skips a beat).
- Weak pulse.
If you are having these symptoms, your provider may order an echocardiogram. An echocardiogram is an ultrasound of your heart. Your provider may also order a CT scan or MRI of your chest, a chest x-ray, or an electrocardiogram (ECG or EKG). Upon physical examination by your provider, you may have low blood pressure when breathing deeply, rapid breathing, fast heart rate (greater than 100 beats per minute depending upon your normal heart rate), bulging neck veins, weak pulse, and faint heart sounds.
How is cardiac tamponade managed?
Cardiac tamponade is an emergency. The extra fluid or blood needs to be removed from the pericardium.
Management may include:
- Fluids – Intravenous (IV, into a vein) fluids are given to maintain a normal blood pressure since the heart cannot.
- Medications – Medications that raise blood pressure may be given.
- Oxygen – Oxygen may be given to reduce the workload on the heart. Blood carries oxygen to the tissues in the body, so giving oxygen decreases the body’s need for blood flow.
- Pericardiocentesis – Thin needles are used to remove fluid or blood from the pericardium.
- Pericardial Window – A surgery that is done to cut and remove part of the pericardium.
It is also important for the cause of the cardiac tamponade to be found and treated to keep it from happening again.
When should I contact my care team?
If you are having any signs of cardiac tamponade, like those listed above, you must call your provider or call 911 right away. Cardiac tamponade is an emergency.
Abeloff M, Niederhuber JE, Armitage JO, Doroshow, JH, Kastan MB, Tepper, JE. Abeloff’s Clinical Oncology. 5th edition. Philadelphia: Churchill Livingstone; 2014.
Cassady R, Prahlow JA. Sudden death due to cardiac tamponade from malignant pericardial involvement by metastatic lung cancer. Forensic Science, Medicine and Pathology. 2014 Oct 19.
Medline Plus. Cardiac Tamponade. Found at: https://medlineplus.gov/ency/article/000194.htm