Cardiac Tamponade
Definition Cardiac tamponade is a life-threatening condition that occurs when fluid accumulates in the pericardial sac, compressing the heart and impairing its ability to function.
Types
- Acute Cardiac Tamponade: Sudden accumulation of fluid in the pericardial sac.
- Chronic Cardiac Tamponade: Gradual accumulation of fluid in the pericardial sac over a period of time.
Pathophysiology → Fluid accumulation in the pericardial sac compresses the heart. → Compression of the heart impairs its ability to function. → Reduced cardiac output leads to decreased perfusion of vital organs. → Hypotension, tachycardia, and jugular venous distension may occur.
Causes
- Trauma: Chest trauma can cause pericardial effusion.
- Infection: Pericarditis can lead to fluid accumulation in the pericardial sac.
- Cancer: Malignant cells can infiltrate the pericardium and cause fluid accumulation.
- Rheumatic fever: Pericarditis can occur as a complication of rheumatic fever.
- Autoimmune disorders: Conditions like lupus and rheumatoid arthritis can cause pericarditis.
Clinical Features
- Hypotension: Reduced blood pressure.
- Tachycardia: Rapid heart rate.
- Jugular venous distension: Swelling of the jugular veins.
- Muffled heart sounds: Compressed heart prevents normal heart sounds.
- Pulsus paradoxus: Decreased pulse pressure during inspiration.
Investigations
- Chest X-ray: Enlarged cardiac silhouette.
- Electrocardiogram (ECG): Low voltage QRS complex.
- Echocardiogram: Fluid accumulation in the pericardial sac.
- Computed Tomography (CT): Fluid accumulation in the pericardial sac.
Complications
- Cardiac arrest: Reduced cardiac output can lead to cardiac arrest.
- Pulmonary edema: Fluid accumulation in the lungs.
- Respiratory failure: Reduced lung function.
Management 1 → Pericardiocentesis: Removal of fluid from the pericardial sac. 2 → Drainage: Placement of a pericardial catheter for continuous drainage. 3 → Medical treatment: Treatment of underlying condition causing pericardial effusion.
Treatment
- Antibiotics: For bacterial pericarditis.
- Corticosteroids: For autoimmune disorders.
- Chemotherapy: For cancer-related pericardial effusion.
Homoeopathic Therapeutic Medicines
- Arsenicum album: For cardiac tamponade due to infection.
- Dulcamara: For cardiac tamponade due to trauma.
- Lachesis: For cardiac tamponade due to cancer.
- Pulsatilla: For cardiac tamponade due to autoimmune disorders.
Important Points
- Pericardiocentesis: Should be performed under echocardiographic guidance.
- Cardiac arrest: May occur due to reduced cardiac output.
- Pulmonary edema: May occur due to fluid accumulation in the lungs.