Cardiac tamponade history and symptoms

Overview

Patients with cardiac tamponade may present with sudden onset of chest pain, palpitations, breathlessness and lightheadedness. Presentation vary with the cause and acuteness of the tamponade.

• Acute cardiac tamponade following trauma to chest or rupture of aorta or heart.
• Sub-acute cardiac tamponade occurs in the setting of neoplasm or renal failure.
• Low pressure cardiac tamponade occurs in patients who are hypovolemic secondary to hemorrhage or overdiuresis.

History and Symptoms

Patients may present with sudden onset of:

• Chest pain
• Palpitations
• Breathlessness
• Tachypnea
• Lightheadedness

Presentation vary with the cause and acuteness of the tamponade. Such as:

• Acute: Cardiac tamponade may develop rapidly in the setting of trauma, rupture of heart or aorta, or as a complication during thoracic surgery. This is often a life threatening condition mandating emergent intervention to relieve high pericardial pressure. These patients may present with features of cardiogenic shock- hypotension, cold clammy extremities, peripheral cyanosis, and decreased urine output.

• Sub-acute: Patients may be asymptomatic to begin with. But as pericardial fluid accumulates over few days to weeks, the intrapericardial pressure reaches a threshold and the patients present with peripheral edema in addition to above listed symptoms. Sub-acute tamponade is associated with neoplastic, uremic, or idiopathic pericarditis.

• Low pressure cardiac tamponade: is a subset of sub-acute tamponade. This occurs in patients who are hypovolemic secondary to hemorrhage or overdiuresis.

Symptoms based on etiology

• Weight loss and cachexia in malignancy.
• Joints and muscular pain in connective tissue disorders.
• Night sweats, fever, and weight loss in tuberculosis

References

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