Let's learn about the dangerous condition of fluid around the heart (Cardiac Tamponade)

Have you ever had a strange pain in your chest, like a feeling of heaviness or pressure, or difficulty breathing? Sometimes, behind these symptoms, there may be a serious medical condition that we don't realize. Cardiac Tamponade is such an emergency that requires immediate treatment. Let's talk about this simply and precisely.

What is Cardiac Tamponade? Let's understand it simply.

Imagine that our heart is inside a protective sac. We call this sac the pericardium. It has two layers. There is a very small amount of fluid between these two layers to help the heart move smoothly and without any problems when it beats.

Cardiac tamponade occurs when too much blood, pus, or other fluid builds up inside that sac. Then, because the fluid has nowhere to go, it starts to compress and squeeze the heart.

This pressure prevents the chambers of the heart from filling properly. If the heart is not filled with blood properly, it cannot pump the amount of blood that the body needs. As a result, your blood pressure drops suddenly . In an attempt to control this condition, the heart starts beating faster, more than 100 times per minute.

What is the difference between Pericardial Effusion and Cardiac Tamponade?

You may have heard the term Pericardial Effusion . Simply put, it is the accumulation of fluid inside the sac around the heart that we medically call Pericardial Effusion.

But remember, not every Pericardial Effusion becomes Cardiac Tamponade. Think of it this way, this fluid builds up slowly, over months. Then the sac around the heart has time to stretch a little and get bigger. So you may not have any major symptoms.

However, if this accumulated fluid puts pressure on the heart, disrupts its function , and prevents it from pumping blood properly, then that is what we call cardiac tamponade.

What are the symptoms of Cardiac Tamponade?

These symptoms can be divided into two categories based on how they occur. That is, symptoms can vary depending on whether the condition occurs suddenly or develops slowly over time.

What causes this situation?

There can be several causes of cardiac tamponade.

Trauma

• Accident: Injury to the chest from something like a car accident or fall.
• Sharp weapon injuries: Chest injuries from something like a knife stab.

Medical conditions

• Aortic dissection .
• Advanced cancer .
• Heart attack .
• Tuberculosis (TB) .
• Infections or inflammation of the sac around the heart.
• Some autoimmune diseases, for example, lupus and rheumatoid arthritis .
• Cancer of the heart.
• Heart or kidney failure.
• Decreased thyroid function (Hypothyroidism) .

After medical treatment

Sometimes this condition can also occur as a side effect of medical treatment.

• Surgery on or related to the heart.
• Catheter-based procedures .
• Implantation of a device such as a pacemaker .
• Radiation therapy to the heart area.

How is Cardiac Tamponade Diagnosed?

When you go to the hospital, the doctor will first examine you.

• I'm watching your pulse rate.
• Blood pressure is measured.
• Checks breathing.
• The heart and lungs are listened to with a stethoscope.
• They check for a symptom called pulsus paradoxus , which is when your blood pressure drops abnormally every time you breathe.

Beck's Triad

There are three specific features that doctors use to diagnose this condition. We call it Beck's triad .

• Low blood pressure (hypotension) .
• The veins in the neck appear to be bulging.
• Hearing the heartbeat very far away, low, when listening with a stethoscope.

But these three symptoms do not occur in every patient.

Diagnostic tests

• Echocardiogram (Echo): This is the most important test. It's like a scan of the heart. It can clearly see how much fluid is around the heart and how stiff the heart is.
• Chest X-ray: An X-ray examination of the chest.
• CT scan: A computerized tomography scan.
• Electrocardiogram (EKG): A test of the electrical activity of the heart.
• Heart catheterization: Passing a catheter into the heart and measuring the pressure.

How is it treated?

The main and immediate treatment for this is to remove the fluid that has accumulated around the heart .

Doctors often perform a procedure called pericardiocentesis , which involves inserting a needle into the sac around the heart and removing the excess fluid.

But sometimes surgery is necessary.

• If this situation has arisen due to an accident.
• If you need to repair internal damage.
• If the needle cannot reach the area where the fluid has collected.
• If you need to remove the sac around your heart.

In addition, the underlying cause of the cardiac tamponade also needs to be treated. Accordingly, you will be given painkillers, antibiotics, or other medications.

Recovery and what to do next

You will feel immediate relief after the extra fluid around your heart is removed. If more fluid builds up, a drainage tube may be left in place for a day or two to drain it.

After you go home from the hospital, it is very important to take the medication prescribed by your doctor exactly on time . Also, be sure to attend follow-up appointments. This condition can recur. Therefore, it is important to continue monitoring the underlying condition.