Cardiac tamponade

ESC CardioMed ◽  
2018 ◽  
pp. 1575-1580
Author(s):  
Arsen D. Ristić ◽  
Petar M. Seferović ◽  
Bernhard Maisch ◽  
Vladimir Kanjuh
Keyword(s):  
Cardiac Output ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Interventional Procedures ◽  
Loop Diuretics ◽  
Diastolic Filling ◽  
Pericardial Space ◽  
Pericardial Diseases

Cardiac tamponade is a pericardial syndrome characterized by compression of the heart by the exudate accumulating within the pericardial space and impairing diastolic filling and cardiac output. Pericardial diseases of any aetiology but also haemorrhage during interventional procedures may cause tamponade. If pericardial effusion accumulates slowly, 2000 mL or more could be tolerated (unless precipitated by dehydration, loop diuretics, vasodilators, anticoagulants, or thrombolytics), but acute accumulation of more than 250 mL is fatal.

Constrictive pericarditis

2021 ◽  
pp. 707-714
Author(s):  
Alida L.P. Caforio ◽  
Maurizio Galderisi ◽  
Massimo Imazio ◽  
Renzo Marcolongo ◽  
Yehuda Adler ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Diastolic Filling ◽  
Purulent Pericarditis ◽  
Immune Mediated ◽  
Pericardial Diseases ◽  
Bacterial Pericarditis ◽  
Risk Of Progression ◽  
Final Evolution

Constrictive pericarditis is a pericardial syndrome where the pericardium becomes relatively rigid and inelastic, may be thickened and calcified or not, and impairs mid to late diastolic filling. Constrictive pericarditis is the final pathway of several different diseases or causes, usually starting from pericarditis and pericardial effusion, and progressing towards pericardial fibrosis and calcification. Constrictive pericarditis is commonly the final evolution of any type of pericarditis and pericardial effusion. The risk of developing such evolution is especially related to the aetiology. The risk of progression is especially related to the aetiology: low (<1%) in viral and idiopathic pericarditis, intermediate (2–5%) in immune-mediated pericarditis and neoplastic pericardial diseases, and high (20–30%) in bacterial pericarditis, especially purulent pericarditis. It is important to recognize transient (subacute) constrictive pericarditis early on in the process versus calcific chronic constrictive pericarditis.

scholarly journals Life-threatening Development of Cardiac Tamponade in the Span of 24 Hours

2019 ◽  
Vol 3 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Patrick Kishi ◽  
Thaer Ahmad ◽  
Kenneth Dodd
Keyword(s):  
Cardiac Output ◽  
Cardiac Tamponade ◽  
Effective Treatment ◽  
Medical Emergency ◽  
Emergency Physicians ◽  
Pericardial Space ◽  
Severe Hypotension ◽  
Life Threatening

Cardiac tamponade is a medical emergency that requires immediate treatment. Caused by the development of fluid in the pericardial space, it can result in a severe decrease in cardiac output. When encountering patients with severe hypotension and tachycardia, emergency physicians must always consider the diagnosis of tamponade to facilitate prompt and effective treatment and stabilization. We report our experience with a patient who developed life-threatening cardiac tamponade within a span of less than 24 hours.

scholarly journals Surgical management of pericardial diseases

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Aamir Bilal ◽  
Salim M ◽  
Salman Nishtar ◽  
Tahira Nishtar ◽  
Muhammad Shoaib Nabi ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Inflammatory Process ◽  
Surgical Excision ◽  
Diastolic Filling ◽  
Purulent Pericarditis ◽  
Chronic Inflammatory Process ◽  
Pericardial Diseases ◽  
Common Causes ◽  
Pericardial Thickening

Tuberculosis and purulent pericarditis are the most common causes of pericardial effusion and constriction. Chronic constrictive pericarditis is a chronic inflammatory process that involves both fibrous and serous layers of the pericardium and leads to pericardial thickening and compression of the ventricles. The resultant impairment in diastolic filling reduces cardiac function. Pericardiectomy remains the treatment of choice for chronic constriction. A review of 72 cases at department of Cardiothoracic Surgery, Lady Reading Hospital is presented. There was a mortality of 12% and a morbidity of 20%. Forty seven of the 72 cases were tuberculous. The surgical excision of pericardium remains the only available curative treatment for constrictive pericarditis, while open pericardial drainage is required for cardiac tamponade resulting from pericardial effusion.

Pericardial Diseases

2018 ◽  
Author(s):  
David W. Schoenfeld
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Constrictive Pericarditis ◽  
Incidental Finding ◽  
Systemic Disease ◽  
Acute Pericarditis ◽  
Pericardial Disease ◽  
Pericardial Cavity ◽  
Pericardial Diseases ◽  
Wide Range

Diseases of the pericardium represent a wide range of clinical syndromes that vary substantially in severity, from a benign pericardial effusion to fatal constrictive pericarditis or hemopericardium. Acute pericarditis is the most common pericardial disease, with viral and idiopathic as the most frequent etiologies. Typically, acute pericarditis can be managed as an outpatient with dual-agent therapy consisting of aspirin or nonsteroidal anti-inflammatory drug plus colchicine and rarely requires admission. Pericardial effusions are fluid collections in the pericardial cavity. They are a common incidental finding, can be associated with other systemic disease, and at their extreme, cause life-threatening cardiac tamponade. Cardiac tamponade exists on a spectrum with patients who are quasi stable to those where cardiovascular collapse and death are imminent. Cardiac tamponade may be temporized with fluid boluses, but treatment is through pericardiocentesis and occasional surgical intervention. Constrictive pericarditis is progressive process with poor prognosis in which the pericardium becomes rigid and causes diastolic dysfunction, leading to heart failure. Once the diagnosis is made, definitive management is surgical but carries a high operative risk. This review contains 7 highly rendered figures, 5 videos, 3 tables, and 42 references. Key Words: cardiac tamponade, constrictive pericarditis, effusive-constrictive pericarditis, pericardial effusion, pericarditis, pericardiocentesis

scholarly journals Cardiac Tamponade in a Patient with Primary Hypothyroidism

2015 ◽  
Vol 1 (1) ◽  
pp. 7-9
Author(s):  
R Katyayini ◽  
R Chikkananjaiah
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Rare Event ◽  
Primary Hypothyroidism ◽  
Common Disease ◽  
Elderly Female ◽  
Pericardial Space ◽  
Multisystem Involvement ◽  
Mild Hypothyroidism

ABSTRACT Hypothyroidism is a common disease with multisystem involvement. It may present clinically in various forms.Pericardial effusion (PE) is one of the cardiovascular manifestation. Pericardial effusion is the accumulation of fluid in the pericardial space. The occurrence of pericardial effusion in hypothyroidism appears to be frequent manifestation of severe myxedema, than in mild hypothyroidism. The incidence of pericardial effusion in hypothyroidism is 3 to 6%. However, the incidence of cardiac tamponade in patients with hypothyroidism is rare event. The slow accumulation of liquid in the pericardial space leads to the rarity of hemodynamic premonitory signs, even in presence of large effusions. In this article, we report an elderly female presented with features of hypothyroidism and pericardial effusion which rapidly developed into cardiac tamponade. She did not have premonitory hemodynamic signs. How to cite this article Katyayini R, Rekha NH, Chikkananjaiah R. Cardiac Tamponade in a Patient with Primary Hypothyroidism. J Med Sci 2015;1(1):7-9.

Pericardial disease

2018 ◽  
Author(s):  
David Adlam
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Acute Inflammation ◽  
Small Volume ◽  
Pericardial Fluid ◽  
Clinical Spectrum ◽  
Fluid Accumulation ◽  
Pericardial Disease ◽  
Pericardial Space ◽  
Pericardial Diseases

The pericardium forms a continuous sac around the heart, analogous to the pleura surrounding the lungs, and the peritoneum surrounding the abdominal viscera. Between the parietal and visceral layers of the serous pericardium is the pericardial space, which normally contains a small volume of pericardial fluid. The clinical spectrum of pericardial diseases can be divided into: pericarditis, caused by acute inflammation; pericardial effusion, or fluid accumulation in the pericardial space, leading to tamponade; and constrictive pericarditis, caused by chronic infiltration or inflammation leading to pericardial constriction.

scholarly journals Clinical Characteristics of Patients with Pericardial Effusion

2021 ◽  
Vol 10 (1) ◽  
pp. 16-19
Author(s):  
Madhab Bista ◽  
Rajesh Nepal ◽  
Manoj Aryal ◽  
Sushant Katwal ◽  
Manoj Kumar Thakur
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
Eastern Region ◽  
Pericardial Diseases ◽  
Common Causes ◽  
The Common

Background: Pericardial effusion (PE) is one of the common pericardial diseases in our population with its associated morbidity and mortality. Our study aims to evaluate the   clinical characteristics of patients with PE from eastern region of Nepal. Materials and Methods: A descriptive cross-sectional study carried out in tertiary care center in eastern region of Nepal from March 2019 to February 2020. A total of 45 cases of PE were enrolled by convenient sampling method. Diagnosis was made based on clinical history, examination, and relevant laboratory investigations. Data was entered in Microsoft excel 2007 and converted into IBM SPSS data editor, version 20. Results: Forty five patients were included with mean age of 55.36 ± 16.38 years. Twenty seven patients (60%) were male and 18 (40%) were female.  Hypertension was present in 12 (26.7%) and diabetes mellitus in 13 (28.9%).  Mean serum hemoglobin was 10.85 ± 2.09 gm/dl. Chronic kidney disease (Uremia), tuberculosis and hypothyroidism were the common causes of PE. Common clinical symptoms were dyspnea, fever, and cough and chest pain. Moderate to large pericardial effusion was noted in 21 (46.7%) of patients. Cardiac tamponade was present in 6 (13.3%). Twenty seven patients (60%) patients underwent pericardiocentesis. Conclusion: Chronic kidney disease, tuberculosis and hypothyroidism were the common causes of PE with male predominance. Dyspnea was the most common presenting symptom.  Cardiac tamponade was relatively less common.

Nonlinear mechanics of the heart's swinging during pericardial effusion

1989 ◽  
Vol 257 (4) ◽  
pp. H1292-H1305
Author(s):  
D. R. Rigney ◽  
A. L. Goldberger
Keyword(s):  
Heart Rate ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Equation Of Motion ◽  
Nonlinear Mechanics ◽  
Pericardial Space ◽  
Buoyancy Forces ◽  
Great Vessels

When excessive fluid accumulates in the pericardial space, the heart, suspended by the great vessels, is then free to swing as a pendulum. The swinging may occur at either the same frequency as the heart rate (1:1 oscillation) or at half the heart rate (2:1 oscillation), the latter frequency often arising during cardiac tamponade. We show that these two frequencies of oscillation may be explained by the nonlinearity of Newton's equation of motion as applied to the heart. Terms in the equation correspond to gravitational and buoyancy forces, forces due to ejection of blood into the great vessels, and damping forces. A transition between the 1:1 and 2:1 swinging is found to occur when particular parameters of the model are changed, notably when there is an increase of heart rate. This finding is compatible with previous clinical reports.

scholarly journals Preoperative and perioperative management of patients with pericardial diseases

2011 ◽  
Vol 58 (2) ◽  
pp. 45-53 ◽  
Author(s):  
Arsen Ristic ◽  
Dejan Simeunovic ◽  
Ivan Milinkovic ◽  
Jelena Seferovic-Mitrovic ◽  
Ruzica Maksimovic ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Pericardial Effusion ◽  
Surgical Procedure ◽  
Elective Surgery ◽  
Hemodynamic Instability ◽  
Systemic Resistance ◽  
Positive Pressure ◽  
Low Cardiac Output ◽  
Pericardial Diseases ◽  
Elective Surgical Procedure

Hemodynamic instability is the major concern in surgical patients with pericardial diseases, since general anesthesia and positive pressure ventilation may precipitate cardiac tamponade. In advanced constriction diastolic impairment and myocardial fibrosis/atrophy may cause low cardiac output during and after surgery. Elective surgery should be postponed in unstable patients with pericardial comorbidities. Pericardial effusion should be drained percutaneously (in local anesthesia) and pericardiectomy performed for constrictive pericarditis before any major surgical procedure. In emergencies, volume expansion, catecholamines, and anesthetics keeping cardiac output and systemic resistance should be applied. Etiology of pericardial diseases is an important issue is the preoperative management. Patients with neoplastic pericardial involvement have generally poor prognosis and any elective surgical procedure should be avoided. For patients with acute viral or bacterial infection or exacerbated metabolic, uremic, or autoimmune diseases causing significant pericardial effusion, surgery should be postponed until the causative disorder is stabilized and signs of pericarditis have resolved.

scholarly journals Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110360
Author(s):  
Lardinois Benjamin ◽  
Goeminne Jean-Charles ◽  
Miller Laurence ◽  
Randazzo Adrien ◽  
Laurent Terry ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Cardiac Toxicity ◽  
Checkpoint Inhibitors ◽  
Final Diagnosis ◽  
Pericardial Fluid ◽  
Malignant Pericardial Effusion ◽  
Typical Cell ◽  
High Fluorescence ◽  
Tomography Scan

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

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