Pericardial Tamponade
What Is It, Causes, Pericardial Effusion, Signs, Diagnosis, Treatment, and More
What is pericardial tamponade?

What causes pericardial tamponade?
What is the difference between pericardial effusion and cardiac tamponade?
Pericardial effusion happens when pericardial fluid builds up slowly over time, which allows the pericardium to stretch out to accommodate bigger and bigger volumes of fluid without compressing the heart. At first, pericardial effusion can be asymptomatic. Over time, however, it can cause chest pain, shortness of breath, and compression of near structures. Ultimately, if the pressure inside the pericardial cavity increases enough to compress the heart muscle, it may lead to pericardial tamponade.
On the other hand, when there’s a sudden fluid accumulation, the pericardium has no time to adjust, so even small amounts can cause a dramatic increase of pressure inside the pericardial sac, resulting in acute pericardial tamponade.What are the three signs of cardiac tamponade?
How do you diagnose pericardial tamponade?
Diagnosis of a pericardial tamponade is suspected in individuals with low blood pressure and jugular vein distention in the presence of a pericardial effusion. To confirm diagnosis, individuals should be evaluated with a chest X-ray, an echocardiogram, and an electrocardiogram (EKG).
A chest X-ray may demonstrate an enlargement of the heart silhouette, known as the “water bottle sign”, in the presence of a large pericardial effusion. Nonetheless, a normal chest x-ray doesn’t rule out cardiac tamponade, as small pericardial effusions can be invisible on an x-ray, but still might lead to cardiac tamponade if they develop rapidly enough.An echocardiogram can detect the presence of even small pericardial effusions. Echocardiographic signs that suggest pericardial tamponade include right-side chamber collapse during heart filling or diastole, distension of the inferior vena cava and the appearance of a swinging heart moving inside the pericardial cavity. In addition, an echocardiogram can identify some of the causes of cardiac tamponade, such as an aortic rupture.
An EKG may demonstrate low voltage QRS complexes, increased heart rate and electrical alternans, which are beat to beat changes in the shape of the QRS complexes due to the swinging of the heart in a large effusion.