Cardiac Tamponade

The experienced cardiologists and cardiothoracic surgeons at UT Southwestern Medical Center work to save the lives of people with cardiac tamponade – and to identify and treat its underlying causes in those who experience this life-threatening heart emergency. 

Skilled Treatment for a Heart Emergency

Cardiac tamponade is an emergency, life-threatening condition in which fluid accumulates (effusion) rapidly in the pericardium, the membrane surrounding the heart.

This fluid quickly compresses the heart, preventing it from adequately pumping blood because it cannot fill properly.

UT Southwestern’s skilled heart doctors use a variety of treatments – both nonsurgical and surgical – to save the lives of people with cardiac tamponade. They also strive to diagnose and treat the underlying cause of the fluid accumulation in people who survive.

UT Southwestern is also home to a dedicated Cardiac Rehabilitation Program. Cardiac rehabilitation is a critical component of recovery and can prevent future heart disease.

Causes of Cardiac Tamponade

Causes of cardiac tamponade can include:

• Pericardial effusion: Abnormal buildup of fluid in the pericardial cavity or between the heart and the pericardium
  
• Connective tissue disorders
• Drugs
• Infection
• Pericarditis: Inflammation of the pericardium 
• Pneumopericardium: Air in the pericardial cavity
• Radiation therapy for cancer treatment
• Surgery
• Trauma
• Uremia: Presence of creatinine and urea in the bloodstream

Cardiac Tamponade Symptoms

Cardiac tamponade can cause symptoms that include:

• Chest pain (angina)
• 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)

Diagnosing Cardiac Tamponade

Although there are no specific diagnostic studies for cardiac tamponade, the doctor might conduct several tests to detect it. These include:

• Electrocardiography (echo or cardiac ultrasound): To visualize the heart’s structure and function using a noninvasive imaging test
  
• Blood pressure check: To detect pulsus paradoxus, an abnormal decrease in systolic blood pressure when inhaling
• Cardiac catheterization: To determine whether left and right atrial pressures are equal
• Chest X-ray: To look for an enlarged heart
• Physical exam, including listening with a stethoscope for distant heart sounds and dullness with bronchial breathing over the left scapula (Ewart sign)

Treatment for Cardiac Tamponade

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
• Volume expansion with IV fluids: To help maintain the heart's volume
• 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
• Implantation of a pericardio-peritoneal shunt to relieve cancer patients whose disease is causing the fluid accumulation
• Pericardiectomy to remove the pericardium as a last resort

Support Services

UT Southwestern’s cardiac rehabilitation specialists will create a customized plan that makes nutrition, exercise, and nicotine cessation programs an integral part of a patient’s daily routine after treatment for cardiac tamponade.

Clinical Trials

Clinical trials often give patients access to leading-edge treatments that are not yet widely available. Eligible patients who choose to participate in one of UT Southwestern’s clinical trials might receive treatments years before they are available to the public.