Tamponad

Tamponad, also referred to as tamponade, is a medical condition characterized by the compression of a hollow organ or tissue due to the accumulation of fluid, blood, or gas within a closed space. The most clinically significant form is cardiac tamponade, in which fluid collects in the pericardial sac surrounding the heart and raises intrapericardial pressure, restricting diastolic filling.

In cardiac tamponade, the limited filling reduces stroke volume and cardiac output, potentially leading to shock. The onset can be acute, with rapid deterioration, or subacute, where gradual fluid accumulation allows compensatory mechanisms. Clinical signs may include low blood pressure, elevated jugular venous pressure, and muffled heart sounds (Beck’s triad), though this triad is not always present. Pulsus paradoxus and tachycardia are common, with shortness of breath and chest discomfort also reported.

Causes of tamponad include malignancy, infectious or inflammatory pericarditis, uremia, post-surgical bleeding, blunt or penetrating trauma, myocardial infarction, and anticoagulation-related hemorrhage. Pericardial effusion can be detected by echocardiography, which commonly shows a fluid collection with diastolic collapse of the right atrium or right ventricle. Electrocardiography may reveal low voltage QRS complexes or electrical alternans; chest radiography can show an enlarged cardiac silhouette if effusion is large or chronic.

Treatment depends on hemodynamic status. Emergent pericardiocentesis is required for unstable patients; stable cases may be managed with pericardial drainage via pericardial window or less invasive methods, and by addressing the underlying cause. Prognosis depends on the rapidity of onset and the underlying etiology, with timely intervention improving outcomes.