What Is Pericardial Tamponade?

The heart is the power organ that maintains human blood circulation, and it guarantees the blood supply to all organs and tissues throughout the body. The pericardium is a sac-like structure that surrounds the heart and the roots of large blood vessels in and out of the heart. The pericardial cavity refers to the space between the parietal pericardium and the visceral pericardium on the surface of the heart. A small amount of pale yellow liquid in the normal pericardial cavity lubricates the surface of the heart. The accumulation of blood in the pericardial cavity caused by traumatic rupture of the heart or damage to the blood vessels in the pericardium is called hemopericardium or pericardial tamponade, which is the cause of rapid death from cardiac trauma. Due to the limited elasticity of the pericardium, acute pericardial hemorrhage of up to 150ml can limit blood return to the heart and heart beat, causing acute circulatory failure and further cardiac arrest.

Pericardial tamponade

Pericardial tamponade

Pericardial tamponade concept

The heart is the power organ that maintains human blood circulation, and it guarantees the blood supply to all organs and tissues throughout the body. The pericardium is a sac-like structure that surrounds the heart and the roots of large blood vessels in and out of the heart. The pericardial cavity refers to the space between the parietal pericardium and the visceral pericardium on the surface of the heart. A small amount of pale yellow liquid in the normal pericardial cavity lubricates the surface of the heart. The accumulation of blood in the pericardial cavity caused by traumatic rupture of the heart or damage to the blood vessels in the pericardium is called hemopericardium or pericardial tamponade, which is the cause of rapid death from cardiac trauma. Due to the limited elasticity of the pericardium, acute pericardial hemorrhage of up to 150ml can limit blood return to the heart and heart beat, causing acute circulatory failure and further cardiac arrest.

Pericardial tamponade

Pericardial tampon therapy

Therefore, once the pericardial pericardium appears, you must race against time for rescue treatment. When the chest wall wound of a sharp injury is in the anterior heart area or the chest is crushed, the patient has a progressive decrease in blood pressure, a pale complexion, a rapid heart rate, a distant heart sound, a jugular vein irritation, and an uneasy consciousness. The blood should be considered first. The presence of the pericardium should be urgently performed for pericardial puncture, blood decompression, relief of tamping, temporary improvement of hemodynamics, fight for rescue time, and infusion of saline and blood to correct hemorrhagic shock. At the same time, prepare for emergency thoracotomy surgery exploration, strict anesthesia management, and prevent Cardiac arrest, replenishing enough blood, removing pericardial hemorrhage during surgery, restoring normal contraction and diastolic function of the heart, and repairing the damaged heart finely and accurately. Cardiac function was closely monitored after surgery and cardiovascular active drugs were used reasonably.

Pericardial tampon symptoms and signs

(1) Fibrinous pericarditis:

Pain in the precardiac area, sternum or subxiphoid is the main manifestation. It can be mild discomfort, pressure, or sharp pain. The pain can radiate to the edge of the trapezius, left shoulder, arm, and back. It can be aggravated when coughing, deep breathing, and supine position, and it can be relieved when prone.

The pericardial friction sound is an important sign, which is most clear in the 3rd to 4th intercostal space of the left margin of the sternum.

(2) exudative pericarditis: due to the heart and adjacent organs being squeezed, often:

Precardiac discomfort, dyspnea, cough, nausea, epigastric pain, hoarseness and difficulty swallowing.

The signs vary depending on the amount of effusion. Apical pulsation weakened or disappeared. The heart dullness world expands to both sides, and the relative dullness world disappears. Fast heart rate, weak and distant heart sounds.

often have fever, shortness of breath, dry cough and hoarseness, difficulty swallowing, etc. In addition, there may be anorexia or epigastric tightness, fatigue, irritability and so on. When there is a large amount of fluid, the percussion of the left subscapula is dull, the speech tremor is enhanced, and the tubular breathing sound is the Yule feature (ewart sign). The pulse is weak and has strange pulses. The systolic blood pressure decreases and the pulse pressure is small. Subacute or chronic pericarditis may appear jugular vein irritation, positive liver-neck reflux, liver enlargement, subcutaneous edema, and ascites.

(3) Acute pericardial tamponade: due to a large amount of pericardial effusion or a rapidly growing small amount of effusion, ventricular diastole is blocked, the cardiac output is reduced, and the clinical manifestations are acute circulatory failure, such as decreased blood pressure, increased heart rate, dyspnea, Aster, pale, sweating, jugular veins, etc.

^[1]