Cardiac tamponade natural history, complications and prognosis: Difference between revisions
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__NOTOC__ | |||
{{Cardiac tamponade}} | |||
{{CMG}} ;{{AE}} {{RG}} | |||
==Overview== | |||
[[Cardiac tamponade]] is a life-threatening condition requiring urgent intervention to remove the pericardial fluid. Complications include [[pulmonary edema]], [[cardiac failure]], [[cardiogenic shock]] and ultimately death. | [[Cardiac tamponade]] is a life-threatening condition requiring urgent intervention to remove the pericardial fluid. Complications include [[pulmonary edema]], [[cardiac failure]], [[cardiogenic shock]] and ultimately death. | ||
==Natural History and Complications== | Cardiac tamponade has a good prognosis if detected early and treated immediately. Short-term survival is mostly dependent on early diagnosis and relief of tamponade. Long-term survival depends upon the prognosis of the underlying cause, irrespective of the mode of treatment. | ||
[[Cardiac tamponade]] is a life-threatening condition requiring urgent intervention to remove the fluid from the pericardial cavity. If untreated, patient may develop following complications: | ==Natural History, Complications, and Prognosis== | ||
*[[Pulmonary edema]] due to decreased forward flow of blood from left ventricle and increased pressures within the pulmonary vasculature. | ===Natural History=== | ||
* Because of restrictive manners of cardiac tamponade , it causes [[acute heart failure]] and increase in blood [[Hydrostatic pressure|hydro-static pressure]].<ref name="WeitzmanTinker1984">{{cite journal|last1=Weitzman|first1=L B|last2=Tinker|first2=W P|last3=Kronzon|first3=I|last4=Cohen|first4=M L|last5=Glassman|first5=E|last6=Spencer|first6=F C|title=The incidence and natural history of pericardial effusion after cardiac surgery--an echocardiographic study.|journal=Circulation|volume=69|issue=3|year=1984|pages=506–511|issn=0009-7322|doi=10.1161/01.CIR.69.3.506}}</ref> | |||
* In severe forms, increase in hydro-static pressure and decompensated left and right heart failure causes [[pulmonary edema]], low blood pressure,low brain blood supply and eventually death. | |||
===Complications=== | |||
[[Cardiac tamponade]] is a life-threatening condition requiring urgent intervention to remove the fluid from the pericardial cavity. If untreated, the patient may develop the following complications<ref name="pmid3716989">{{cite journal| author=Markiewicz W, Borovik R, Ecker S| title=Cardiac tamponade in medical patients: treatment and prognosis in the echocardiographic era. | journal=Am Heart J | year= 1986 | volume= 111 | issue= 6 | pages= 1138-42 | pmid=3716989 | doi= | pmc= | url= }} </ref>: | |||
*[[Pulmonary edema]] due to decreased forward flow of blood from the left ventricle and increased pressures within the pulmonary [[vasculature]]. | |||
*[[Cardiac failure]] secondary to inadequate ventricular filling and cardiac output. | *[[Cardiac failure]] secondary to inadequate ventricular filling and cardiac output. | ||
*[[Cardiogenic shock]] | *[[Cardiogenic shock]] | ||
*Death | *[[Pulseless electrical activity]] | ||
*[[Death]] | |||
==Prognosis== | ===Complications=== | ||
* | ===Prognosis=== | ||
*The prognosis of cardiac tamponade depends upon tow factors: | |||
#The underlying condition | |||
#duration of diagnosis and treatment | |||
*The prognosis of a cardiac tamponade is typically good with early recognition and management of the condition and the underlying causes of the tamponade. 3.2% of the total deaths over a 10-year period were attributable to cardiac tamponade in a postmortem study of 14,368 patients in County of Cornwall, UK between 1995 and 2004.<ref name="pmid17822563">{{cite journal| author=Swaminathan A, Kandaswamy K, Powari M, Mathew J| title=Dying from cardiac tamponade. | journal=World J Emerg Surg | year= 2007 | volume= 2 | issue= | pages= 22 | pmid=17822563 | doi=10.1186/1749-7922-2-22 | pmc=PMC2042492 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17822563 }} </ref> | |||
*Cardiac tamponade caused by [[central venous catheter]]s had a mortality rate of 77% before 1980 and 47% between 1980-1989<ref name="pmid1282555">{{cite journal| author=Nasim A, Cooper GG, Ah-See AK| title=Cardiac tamponade due to central venous catheterization. | journal=J R Coll Surg Edinb | year= 1992 | volume= 37 | issue= 5 | pages= 337-9 | pmid=1282555 | doi= | pmc= | url= }} </ref>. | *Cardiac tamponade caused by [[central venous catheter]]s had a mortality rate of 77% before 1980 and 47% between 1980-1989<ref name="pmid1282555">{{cite journal| author=Nasim A, Cooper GG, Ah-See AK| title=Cardiac tamponade due to central venous catheterization. | journal=J R Coll Surg Edinb | year= 1992 | volume= 37 | issue= 5 | pages= 337-9 | pmid=1282555 | doi= | pmc= | url= }} </ref>. | ||
*Patients with underlying [[malignancy]] has the highest rate of mortality<ref name="pmid11454853">{{cite journal| author=Soler-Soler J, Sagristà-Sauleda J, Permanyer-Miralda G| title=Management of pericardial effusion. | journal=Heart | year= 2001 | volume= 86 | issue= 2 | pages= 235-40 | pmid=11454853 | doi= | pmc=PMC1729838 | url= }} </ref>. Short-term survival is mostly dependent on early diagnosis and relief of tamponade. Long-term survival depends upon the prognosis of the underlying cause, irrespective of the mode of treatment<ref name="pmid3716989">{{cite journal| author=Markiewicz W, Borovik R, Ecker S| title=Cardiac tamponade in medical patients: treatment and prognosis in the echocardiographic era. | journal=Am Heart J | year= 1986 | volume= 111 | issue= 6 | pages= 1138-42 | pmid=3716989 | doi= | pmc= | url= }} </ref>. | *Patients with underlying [[malignancy]] has the highest rate of mortality<ref name="pmid11454853">{{cite journal| author=Soler-Soler J, Sagristà-Sauleda J, Permanyer-Miralda G| title=Management of pericardial effusion. | journal=Heart | year= 2001 | volume= 86 | issue= 2 | pages= 235-40 | pmid=11454853 | doi= | pmc=PMC1729838 | url= }} </ref>. Short-term survival is mostly dependent on early diagnosis and relief of tamponade. Long-term survival depends upon the prognosis of the underlying cause, irrespective of the mode of treatment<ref name="pmid3716989">{{cite journal| author=Markiewicz W, Borovik R, Ecker S| title=Cardiac tamponade in medical patients: treatment and prognosis in the echocardiographic era. | journal=Am Heart J | year= 1986 | volume= 111 | issue= 6 | pages= 1138-42 | pmid=3716989 | doi= | pmc= | url= }} </ref>. | ||
*Tamponade secondary to idiopathic effusion and penetrating chest wounds | *Tamponade secondary to idiopathic effusion and penetrating chest wounds has been shown to be associated with better outcomes with emergent removal of pericardial fluid. | ||
==References== | ==References== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]
Overview
Cardiac tamponade is a life-threatening condition requiring urgent intervention to remove the pericardial fluid. Complications include pulmonary edema, cardiac failure, cardiogenic shock and ultimately death.
Cardiac tamponade has a good prognosis if detected early and treated immediately. Short-term survival is mostly dependent on early diagnosis and relief of tamponade. Long-term survival depends upon the prognosis of the underlying cause, irrespective of the mode of treatment.
Natural History, Complications, and Prognosis
Natural History
- Because of restrictive manners of cardiac tamponade , it causes acute heart failure and increase in blood hydro-static pressure.[1]
- In severe forms, increase in hydro-static pressure and decompensated left and right heart failure causes pulmonary edema, low blood pressure,low brain blood supply and eventually death.
Complications
Cardiac tamponade is a life-threatening condition requiring urgent intervention to remove the fluid from the pericardial cavity. If untreated, the patient may develop the following complications[2]:
- Pulmonary edema due to decreased forward flow of blood from the left ventricle and increased pressures within the pulmonary vasculature.
- Cardiac failure secondary to inadequate ventricular filling and cardiac output.
- Cardiogenic shock
- Pulseless electrical activity
- Death
Complications
Prognosis
- The prognosis of cardiac tamponade depends upon tow factors:
- The underlying condition
- duration of diagnosis and treatment
- The prognosis of a cardiac tamponade is typically good with early recognition and management of the condition and the underlying causes of the tamponade. 3.2% of the total deaths over a 10-year period were attributable to cardiac tamponade in a postmortem study of 14,368 patients in County of Cornwall, UK between 1995 and 2004.[3]
- Cardiac tamponade caused by central venous catheters had a mortality rate of 77% before 1980 and 47% between 1980-1989[4].
- Patients with underlying malignancy has the highest rate of mortality[5]. Short-term survival is mostly dependent on early diagnosis and relief of tamponade. Long-term survival depends upon the prognosis of the underlying cause, irrespective of the mode of treatment[2].
- Tamponade secondary to idiopathic effusion and penetrating chest wounds has been shown to be associated with better outcomes with emergent removal of pericardial fluid.
References
- ↑ Weitzman, L B; Tinker, W P; Kronzon, I; Cohen, M L; Glassman, E; Spencer, F C (1984). "The incidence and natural history of pericardial effusion after cardiac surgery--an echocardiographic study". Circulation. 69 (3): 506–511. doi:10.1161/01.CIR.69.3.506. ISSN 0009-7322.
- ↑ 2.0 2.1 Markiewicz W, Borovik R, Ecker S (1986). "Cardiac tamponade in medical patients: treatment and prognosis in the echocardiographic era". Am Heart J. 111 (6): 1138–42. PMID 3716989.
- ↑ Swaminathan A, Kandaswamy K, Powari M, Mathew J (2007). "Dying from cardiac tamponade". World J Emerg Surg. 2: 22. doi:10.1186/1749-7922-2-22. PMC 2042492. PMID 17822563.
- ↑ Nasim A, Cooper GG, Ah-See AK (1992). "Cardiac tamponade due to central venous catheterization". J R Coll Surg Edinb. 37 (5): 337–9. PMID 1282555.
- ↑ Soler-Soler J, Sagristà-Sauleda J, Permanyer-Miralda G (2001). "Management of pericardial effusion". Heart. 86 (2): 235–40. PMC 1729838. PMID 11454853.