Diagnostico y guia terapeutica del paciente con taponamiento. Hemopericardium, cardiac tamponade, and liver abscess in a. On the ct scan performed after pericardiocentesis the presence of an alreadyidentified pericardial effusion arrow was revealed, but allowed identification of the presence of lung tumors, adenopathy, and an image suggestive of carcinomatous lymphangitis. Pericardial diseases of any aetiology may cause cardiac tamponade, but with. An important pathophysiologic feature of both cardiac tamponade and.
Georges hospital, london, uk correspondence to pete. Dec 12, 2002 pericardial tamponade, an uncommon but often fatal patient event in the neonatal intensive care unit nicu, can be caused by pericardial extravasation of infusate delivered through peripherally. Cardiac tamponade is clinically defined as the accumulation of fluid such as blood in the pericardial sac which alters cardiac filling. The incidence is 2 cases per 10,000 population in the united states of america.
Lany 2008, alguns autors estatunidencs lestimaven en 2 casos10. Meigslike syndrome presenting as cardiac tamponade revista. Cardiac tamponade is a kind of cardiogenic shock and medical emergency. Cardiac tamponade will usually present with hypotension, muffling of heart sounds, and accentuated neck veins. Cardiac tamponade is a medical emergency that requires hospitalization. Cardiac tamponade is caused by the accumulation of blood, fluid, pus, clots, or gas in the pericardial space, resulting in reduced ventricular filling. In our case, we opted for open surgical removal due to association with perforation and cardiac tamponade. Pericardial tamponade, an uncommon but often fatal patient event in the neonatal intensive care unit nicu, can be caused by pericardial extravasation of.
I describe a case of cardiac tamponade whose initial diagnosis was pulmonary embolism in a 72yearold female brought to our hospital with shortness of breath over the last three weeks. Current pericardial evacuation techniques and approaches are varied. Med j malaysia vol 69 no 1 february 2014 39 although diagnosis of cardiac tamponade is often clinical with equivocal findings evaluated with echocardiography as the technique of choice, it is often not feasible due to patient habitus or often not performed due to low clinical suspicion from masked symptomssigns. However, cardiac tamponade is associated with a variety of abnormalities that lead to changes on the electrocardiogram ecg, chest xray, and on. Meigslike syndrome presenting as cardiac tamponade. Cardiac tamponade is caused by the accumulation of fluid in the pericardial space.
Symptoms typically include those of cardiogenic shock including shortness of breath, weakness, lightheadedness, and cough. This occurs with a large pericardial effusion constricts the heart and can lead to shock. Cardiac tamponade is a sudden life threatening condition characterized by the accumulation of pericardial fluid under pressure which decreases the movement of parietal pericardium and compresses all the chambers such that systemic venous return to the ra is compromised 35. Variants include low pressure occult and regional cardiac tamponade. A severe and unusual complication in central lines i. Article pdf available january 2014 with 1,405 reads. The task force for the diagnosis and management of pericardial diseases of the european society of cardiology escendorsed by. Cardiac tamponade is a clinical diagnosis, but assessment of the patients condition. Aug 24, 2011 this is the primary test used to diagnose and manage cardiac tamponade. Cardiac tamponade as cause of respiratory distress and. Article pdf available in bmj case reports 2014dec22 1.
Taponamiento cardiaco enfermedades cardiovasculares. In this condition, blood or fluid collects in the sac surrounding the heart. Pdf cardiac tamponade, a clinical challenge researchgate. Tamponade due to malignancy andor chronic kidney injury occurs more frequently in elderly individuals. In this case report we present and discuss pericarditis leading to cardiac. Clinicians should understand the tamponade physiology, especially because it can develop without large pericardial effusion. Cardiac tamponade, also known as pericardial tamponade, is when fluid in the pericardium the sac around the heart builds up, resulting in compression of the heart. Triage strategy for urgent management of cardiac tamponade. Cardiac tamponade is a serious medical condition in which blood or fluids fill the space between the sac that encases the heart and the heart muscle. Cardiac tamponade resembling an acute myocardial infarction as the initial manifestation of metastatic pericardial adenocarcinoma. Derrame pericardico y taponamiento cardiaco sciencedirect. Although cardiac tamponade is a clinical diagnosis, echocardiography figure 2 provides useful information and is the cornerstone during evaluation availability, bedside, and treatment. It should relieve pressure on your heart and then treat the underlying.
Cronicon open access ec emergency medicine and critical care. In both cardiac tamponade and constrictive pericarditis, cardiac filling is impeded by an external force. Heightened ventricular interdependence coupled with progressive systolic predominance of an inspiratory increase in systemic venous return are largely responsible for the diagnostic physical and imaging signs. Cardiac tamponade related to trauma or hiv is more common in young adults. The visceral pericardium is a serosal monolayer that adheres firmly to the epicardium, reflects over the origin of the great vessels, and together with a tough, fibrous parietal layer, envelops the heart. Nov 28, 2018 cardiac tamponade is a clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise. The treatment of cardiac tamponade has two purposes. Cardiac tamponade is a lifethreatening disorder that can result from any condition that causes a pericardial effusion. Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle and the outer covering sac of the heart.
Tamponamiento cardiaco, pericardiocentesis youtube. Cardiac tamponade is a medical emergency that develops when a pericardial effusion reaches a critical amount, limiting cardiac inflow and leading to hemodynamic compromise. The pericardium is composed of visceral and parietal components. This is the primary test used to diagnose and manage cardiac tamponade. Unexpected resistance to external cardiac compression may. Mar 17, 2015 cardiac tamponade is a medical emergency that develops when a pericardial effusion reaches a critical amount, limiting cardiac inflow and leading to hemodynamic compromise. Cardiac tamponade an overview sciencedirect topics. Pulsus paradoxus and pericardiocentesis are discussed. An echocardiogram showed a 3cm global pericardial effusion with signs of cardiac tamponade figure 1b. Patients suspected of having cardiac tamponade should be evaluated. Intracardiac embolization of inferior vena cava filter. Massive pericardial effusion with cardiac tamponade.
Cardiac tamponade is a clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise. This prevents the heart ventricles from expanding fully. Cateterizacioncardiacaa tubelike instrument inserted into the heart through a vein or artery usually in the arm or leg to detect problems with the heart and its blood supply 14. If the pressure is higher than in the various chambers of your heart, they get compressed and some of. Cardiac tamponade is an emergency situation requiring fast diagnosis and drainage of the pericardial effusion pericardiocentesis or pericardial window. Chest computerized tomography ct of a patient who was admitted with a picture consistent with cardiac tamponade. Role of echocardiography in the treatment of cardiac tamponade. Because cardiac tamponade is a medical emergency, immediate attempts to evacuate the blood from the pericardium is of utmost priority to avoid. The condition is a medical emergency, the complications of which include pulmonary edema, shock, and.
However, after its reserve volume is exceeded, the pericardium markedly stiffens. Massive pericardial effusion and cardiac tamponade as the presentation form of. Hemopericardium, cardiac tamponade and liver abscess 326 neumol cir tora, ol. The normal pericardium can stretch to accommodate physiologic changes in cardiac volume.
Due to the patients clinical instability, drainage of the pericardial effusion was mandatory, but pericardiocentesis was unsuccessful due to catheter obstruction, and so surgical drainage was performed through a pleuropericardial window. European heart journal, volume 35, issue 34, 7 september 2014, pages 2279. Cardiac tamponade cardiac tamponade, which may be acute or subacute, is characterized by the accumulation of pericardial fluid under pressure. Cardiac tamponade results from an accumulation of pericardial fluid under pressure, leading.
In the cardiac catheterization laboratory, tamponade can result as a complication of any invasive procedure and lead to the rapid demise of the patient due to the swift accumulation of fluid in a poorly compliant pericardial. In this case report we present and discuss pericarditis leading to cardiac tamponade as the initial manifestation of csle. Diagnosis and therapeutic management of patients with cardiac. Echocardiography provides valuable insights into identifying patients who are suitable candidates and further facilitates pericardiocentesis by improving guidance. Open surgical drainage with or without pericardiectomy pericardial window. The condition is a medical emergency, the complications of which include pulmonary edema, shock, and death. Taponamiento cardiaco por derrame pericardico masivo secundario a hipotiroidismo primario. Cardiac tamponade as the initial presentation of systemic. Symptom signs and laboratory tests in cardiac tamponade are shown in tables 16. Cardiac tamponade is the result of an accumulation of fluid, pus, blood, gas, or benign or malignant neoplastic tissue within the pericardial cavity, which can occur either rapidly or gradually over time, but eventually, results in impaired cardi. Transthoracic echocardiography tte revealed a large global pericardial effusion measuring 40mm in diameter with swinging of the heart freely in an anteriorposterior fashion fig. Since cardiac tamponade can develop slowly, and the symptoms and signs are neither highly sensitive nor specific, halpern et al.
567 1078 1140 1242 1445 1470 1519 967 1461 1462 822 453 502 449 377 527 726 635 297 530 282 1327 627 202 788 688 1442 827 143 186 1283 1214 713 67 63 562