Cardiac Tamponade

Cardiac tamponade is an emergency, life-threatening condition in which fluid accumulates rapidly in the pericardium, the membrane surrounding the heart, so much that it compresses the heart, like squeezing an orange in your hands.

Consequently, the heart cannot pump blood properly because it cannot fill properly.

Cardiac tamponade is caused by:

  • Connective tissue disorders
  • Drugs
  • Infection
  • Pericarditis
  • Pneumopericardium, a condition in which air enters the pericardial cavity
  • Radiation therapy
  • Surgery
  • Trauma
  • Uremia

Symptoms of Cardiac Tamponade

There are many signs of cardiac tamponade, including:

  • Chest pain
  • Discomfort, sometimes relieved by sitting up or leaning forward
  • High heart rate (tachycardia)
  • High respiratory rate (tachypnea)
  • Low blood pressure (hypotension)
  • Neck vein distension
  • Shortness of breath (dyspnea)

Diagnosis of Cardiac Tamponade

There are no specific tests for cardiac tamponade. However, your doctor may do an echocardiogram to detect it. An echocardiogram is a noninvasive test that sends sound waves from the chest to the heart to create a moving picture of the heart.

Other tests your doctor might perform include:

  • Blood pressure to detect pulsus paradoxus, a decrease in systolic blood pressure greater than 10mmHg when inhaling
  • Cardiac catheterization to determine whether left and right atrial pressures are equal
  • Chest X-ray to detect an enlarged heart
  • Stethoscope to detect distant heart sounds or to detect an area of dullness with bronchial breath sounds over the left scapula (Ewart sign)

Treatment Options for Cardiac Tamponade

A cardiac tamponade requires hospitalization. Common treatments include:

  • Bed rest with leg elevation to reduce the heart's workload
  • Inotropic drugs, such as dobutamine to improve heart function and lower blood pressure
  • Oxygen to reduce the heart's workload
  • Pericardiocentesis to drain the fluid from the pericardium using a needle
  • Surgery:
    • Surgical creation of a pericardial window to allow drainage of the effusion
    • Pericardio-peritoneal shunt to relieve cancer patients whose disease is causing the effusion
    • Pericardiectomy to remove the pericardium, as a last resort
  • Volume expansion with IV fluids to help maintain the heart's volume

Request an Appointment

To schedule an appointment with a heart expert at UT Southwestern's facilities in Dallas or for more information about our services, request an appointment or call 214-645-8300.