Tamponadi

Tamponadi, or cardiac tamponade, is a medical emergency in which fluid, blood, pus, or air accumulates in the pericardial sac, producing pressure that restricts the heart’s diastolic filling and lowers cardiac output.

Symptoms typically include hypotension, a rapid pulse, shortness of breath, and distended neck veins. Muffled heart sounds and pulsus paradoxus may occur in more advanced cases. The clinical picture may progress to shock if not rapidly treated.

Common causes include trauma, cardiac surgery, malignancy with pericardial involvement, infection or autoimmune pericarditis, uremia, and iatrogenic injury during procedures. Tamponade can be acute, developing quickly, or subacute if the fluid accumulates more gradually.

Diagnosis relies on imaging and clinical assessment. Echocardiography is the primary diagnostic tool and often shows a pericardial effusion with diastolic collapse of right-sided heart chambers. Electrocardiography may reveal low voltage QRS complexes or electrical alternans. Additional imaging, such as CT or MRI, can help identify the effusion and underlying causes.

Management requires urgent assessment of stability. In patients with tamponade and instability, emergent pericardiocentesis is performed to drain the fluid and relieve pressure. If feasible, surgical options such as a pericardial window or pericardiectomy may be used for ongoing drainage. Treatment also targets the underlying cause.

Prognosis improves with rapid relief of pressure and addressing the etiology; delays increase the risk of persistent shock and death.