Learning objectives
*To describe the imaging features (X-Ray, US, CT, and MR) of cardiac tamponade.
*To describe imaging features that help to distinguish cardiac tamponade from other cardiac abnormalities.
*To analyze the diagnostic algorithm of cardiac tamponade and to emphasize the importance of its emergent treatment.
Background
The normal pericardium is afibroelastic sac containing a small amount of fluid(10-50 cc) surrounding the heart [Fig 1]. Three pericardial compressive syndromes can develop when larger amounts of fluid accumulate (pericardial effusion) or when the pericardium becomes scarred, thickened, or inelastic:
Cardiac tamponade: characterized by the accumulation of pericardial fluid under pressure.
Constrictive pericarditis
Effusive-constrictive pericarditis
[Fig 2].
Cardiac tamponade is a life-threatening condition.
Prompt diagnosis is essential to reduce the risk of mortality of these patients.
Although cardiac tamponade is a clinical diagnosis, multimodality...
Findings and procedure details
A. PATHOPHYSIOLOGY
Cardiac tamponade can be produced by the accumulation offluid, pus, blood, gas, or tissue. Causes of cardiac tamponade are the same as pericardial effusion [Fig 3], but in different series of cases, an estimated frequency of causes that can develop cardiac tamponade has been described, including [Fig 4].
Different types of cardiac tamponade can be seen depending on the clinical scenario and the onset:
Acute cardiac tamponade (minutes): secondary to trauma, cardiac rupture, or after an invasive diagnostic or therapeutic procedure.
Subacute cardiac...
Conclusion
Radiologists play a key role in identifying cardiac tamponade. Chest CT allows to rule out other abnormalities in the mediastinum or the lungs and to define the nature of the pericardial effusion. Prompt diagnosis is essential to reduce the mortality risk of these patients.
Personal information and conflict of interest
F. Mendoza Ferradas:
Nothing to disclose
D. P. Martín Antonio:
Nothing to disclose
I. Soriano Aguadero:
Nothing to disclose
A. C. Igual Rouilleault:
Nothing to disclose
A. Ezponda Casajus:
Nothing to disclose
J. Pueyo Villoslada:
Nothing to disclose
G. Bastarrika Alemañ:
Nothing to disclose
References
Reddy, P. S., Curtiss, E. I., & Uretsky, B. F. (1990). Spectrum of hemodynamic changes in cardiac tamponade. The American journal of cardiology, 66(20), 1487–1491.
Roy, C. L., Minor, M. A., Brookhart, M. A., & Choudhry, N. K. (2007). Does this patient with a pericardial effusion have cardiac tamponade?.JAMA,297(16), 1810–1818.
Shabetai R, Hoit BD. Cardiac tamponade. UpTo-Date online (13.2). http://www.uptodate.com. Accessed September 20, 2020.
Spodick D. H. (2003). Acute cardiac tamponade. The New England journal of medicine, 349(7), 684–690.
Goldstein, L., Mirvis, S. E., Kostrubiak,...