Cardiac tamponade/History and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S. Ramyar Ghandriz MD[2]
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 development of tamponade. An acute cardiac tamponade follows trauma to the chest or rupture of the aorta or heart. A sub-acute cardiac tamponade occurs in the setting of a neoplasm or renal failure. A low pressure cardiac tamponade occurs in patients who are hypovolemic secondary to hemorrhage or over diuresis.
History and Symptomes
History
Presentation varies with the cause and spontaneity of the tamponade. Such as:[1][2].
- Acute: Cardiac tamponade may develop rapidly in the setting of trauma, rupture of the heart or aorta, or as a complication during thoracic surgery. This is often a life threatening condition mandating emergency 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 a few days to weeks, the intrapericardial pressure reaches a threshold and the patients present with peripheral edema in addition to the symptoms listed above. Sub-acute tamponade is associated with neoplastic, uremic, or idiopathic pericarditis.
- Low pressure cardiac tamponade: This is a subset of sub-acute tamponade. This occurs in patients who are hypovolemic secondary to hemorrhage or over diuresis.
Symptoms
Patients may present with sudden onset of:[3][4][5]
- Anxiety, restlessness
- Chest pain- Sharp and stabbing pain which worsens with deep breathing or coughing.
- Difficulty breathing
- Discomfort, sometimes relieved by sitting upright or leaning forward
- Fainting, light-headedness
- Lightheadedness
- Low blood pressure
- Pale, gray, or blue skin
- Palpitations
- Rapid breathing
- Shortness of breath
- Swelling of the abdomen or other areas
- Syncope/presyncope
- Weak or absent pulse
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
- ↑ Butala A, Chaudhari S, Sacerdote A (February 2013). "Cardiac tamponade as a presenting manifestation of severe hypothyroidism". BMJ Case Rep. 2013. doi:10.1136/bcr-12-2011-5281. PMC 3603423. PMID 23389717.
- ↑ Reddy PS, Curtiss EI, Uretsky BF (1990). "Spectrum of hemodynamic changes in cardiac tamponade". Am J Cardiol. 66 (20): 1487–91. PMID 2251997.
- ↑ Dalia T, Masoomi R, Sahu KK, Gupta K (January 2018). "Cardiac tamponade causing severe reversible hyponatraemia". BMJ Case Rep. 2018. doi:10.1136/bcr-2017-222949. PMC 5775762. PMID 29298795.
- ↑ Carrion DM, Carrion AF (June 2012). "Cardiac tamponade as an initial manifestation of systemic lupus erythematosus". BMJ Case Rep. 2012. doi:10.1136/bcr-03-2012-6126. PMC 4543278. PMID 22693326.
- ↑ Farma J, Nguyen D (January 2005). "Cardiac tamponade". Postgrad Med J. 81 (951): 67. doi:10.1136/pgmj.2004.020768. PMC 1743187. PMID 15640435.
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