Cardiac tamponade

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Cardiac tamponade

Heart, front view

Pericardium

Tamponade; Pericardial tamponade

• Anxiety , restlessness
• Discomfort, sometimes relieved by sitting upright or leaning forward.
• Difficulty breathing
• Rapid breathing
• Fainting , light-headedness
• Chest pain
  • Radiating to the neck, shoulder, back or abdomen
  • Sharp, stabbing
  • Worsened by deep breathing or coughing
• Swelling of the abdomen or other areas
• Skin pale, gray or blue
• Palpitations

Additional symptoms that may be associated with this disease:

• Pulse, weak or absent
• Drowsiness
• Dizziness
• Low blood pressure

Although there are no specific laboratory tests that diagnose tamponade, echocardiogram is first choice to help establish the diagnosis. The heart will often sound uncharacteristically faint during examination with a stethoscope. Peripheral pulses may be weak or absent. Neck veins may be distended but the blood pressure may be low.

The heart rate may be over 100 (normal is 60 to 100 beats per minute), and breathing may be rapid (faster than 12 breaths in an adult per minute). The blood pressure may fall (pulsus paradoxical) when the person inhales deeply.

• Fluid in the pericardial sac may show on:
  • Chest x-ray
  • Echocardiogram
  • Chest CT or MRI of chest
  • Coronary angiography (may show other changes also)
• ECG changes include low voltage wave forms

Review Date: 07/14/2006
Reviewed By: J.A. Lee, M.D., Division of Surgery, UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network.