Cardiac tamponade: a fatal condition that most of us don’t know about

This thin, double-walled sac around the heart is called pericardium.

BENGALURU: While the lifestyle these days has thrown enough light on the concerns related to heart like cardiac arrest, heart failure, heart attack, etc, there still remains one very serious medical condition that is not a result of lifestyle choices really, but is something grave enough to be known about. The condition being referred to here is called cardiac tamponade. To put it simply, it is the compression of the heart due to a fluid being collected in the sac that surrounds the heart. This thin, double-walled sac around the heart is called pericardium.

How it occurs
There is a sac that encloses the heart and the heart muscle. When the space between that sac (pericardium) gets filled with blood or fluids, it results in cardiac tamponade. The filling with the fluid creates a lot of pressure on the heart and the pressure in turn, does not allow the ventricles of the heart to expand completely and hence does not let the heart function properly. The cavity around the heart can fill with bodily fluids or blood enough to compress the heart. As the fluid presses on the heart, it becomes more and more difficult for the blood to enter the heart. Naturally, the amount of blood reaching the heart reduces. As a result, less oxygen-rich blood gets pumped to the rest of the body or the heart is unable to pump blood adequately to the rest of the body which can eventually result in organ failure, shock, and cardiac arrest or can even be fatal.

Symptoms

• Restlessness and anxiety
• Low blood pressure
• Weakness
• Chest pain radiating to your neck, shoulders, or back
• Difficulty in breathing or taking deep breaths
• Fast breathing
• Discomfort that is relieved by sitting or leaning forward
• Dizziness and loss of consciousness Once you observe any of the symptoms, you should seek medical help at the earliest. The diagnosis of cardiac tamponade usually consists of three signs that a doctor recognises, which are also called as Beck’s triad. These signs include:
• Low blood pressure and weak pulse as the volume of the blood being pumped by the heart gets reduced.
• Extended neck veins due to the difficulty they experience in returning blood to the heart.
• A rapid heartbeat along with muffled heart sounds because of the increasing layer of fluid inside the pericardium.

Some other diagnostic tests like an echocardiogram, a thoracic CT scan, a magnetic resonance imaging are also done after the above observations to confirm a cardiac tamponade. However, once diagnosed, cardiac tamponade needs hospital immediate hospitalisation and emergency invasive treatment to relieve pressure on the heart before treating the underlying condition. The patient needs to be stabilised too before the procedures are undertaken.
-The author is consultant - interventional cardiologist, Columbia Asia Hospital Sarjapur Road