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What is Cardiac Tamponade?
- Rapid rise in intrapericardial pressure that impairs the diastolic filling of the heart
- usually from blood/fluid accumulation in pericardial sac
- lower number
- mmHg in arteries between heart beats
- higher number
- mmHg in arteries when the heart beats
How much fluid can the pericardial sac accumulate?
What if the pressure increase is slow?
the pericardial sac will stretch and symptoms/signs will not be evident right away
What are some causes of Cardiac Tamponade?
- effusion (flowing in) of fluid and blood
- hemorrhage (trauma or non-traumatic)
- viral, post irradiation or idiopathic pericarditis
- acute MI
- chronic renal failure during dialysis
- connective tissue disorder
What occurs during Cardiac Tamponade?
fluid puts compression on the heart which limits blood flow into ventricles and reduces amount of blood pumped out of the heart with each contraction
What are the main signs/symptoms of Cardiac Tamponade?
- Beck's Triad
- hypotension with narrowing pulse pressure (low arterial BP)
- neck vein distension
- muffled heart sounds
Besides Beck's triad, what are the signs/symptoms of Cardiac Tamponade?
- pulsus paradoxus
- weak/rapid peripheral pulse
What is orthopnea?
dyspnea when lying down
What is diaphoresis?
what is pulsus paradoxus?
inspiratory drop in systolic BP >15mmHG
What is cyanosis?
blue/purple coloration of the skin
What tests are there for Cardiac Tamponade?
- Chest X-ray- shows widened mediastinum and enlargement of cardiac silhouette
- pulmonary artery pressure monitoring
What are the main treatments for Cardiac Tamponade?
- surgical creation of an opening
- insertion of a drain into the pericardial sac to drain effusion of fluid/blood
needle aspiration of pericardial cavity
What is the treatment for hypotension pts with Cardiac tamponade?
maintain cardiac output by increasing blood volume with IV solution with saline and albumin (protein of blood plasma)
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