Cardiac tamponade
Contents:
Description:
Cardiac tamponade - accumulation in a pericardiac bag of the liquid (an exudate at a pericardis, blood at wound or a cardiorrhesis) interfering sufficient filling of cameras of heart during a diastole with development of an acute heart failure.
Cardiac tamponade symptoms:
The main manifestations - growth of diastolic pressure in auricles and ventricles, disturbance of their filling and falling of cordial emission. If liquid collects quickly, then for emergence of a tamponade there is enough 200 ml and if slowly, then the pericardium stretches and can contain more than 2 l. The critical volume of subjects are more, the walls of ventricles are thicker, and the it is less, than the pericardium is thicker.
The classical triad (Beck's triad) - falling of the ABP, growth TsVD and deaf cardiac sounds - arises only at the heavy acute tamponade caused, for example, by a rupture of a myocardium. At gradual development of a tamponade the clinical picture reminds heart failure: asthma, orthopnea, hepatomegalia, swelling of cervical veins. At arterial hypotonia, swelling of cervical veins and the expressed H-recession of venous pulse it is necessary to suspect a tamponade even if its explicit reason is absent. Unlike chronic cardial compression at a tamponade Y-recession of venous pulse is often reduced or is absent.
Cardiac tamponade reasons:
The cardiac tamponade is possible also at a hemopericardium: after heart operations, at a heart injury (including perforation of heart at catheterization and an angiography, a biopsy of a myocardium and catheter destruction of additional ways of carrying out), tuberculosis and as a result of use of anticoagulants against the background of any acute pericardis.
Treatment of the Cardiac tamponade:
Observe the patient, watch exudate volume. If an exudate big or moderate, the patient is hospitalized not to pass a cardiac tamponade. TsVD and ChSS watch the ABP, several times carry out EhoKG. At emergence of a tamponade the emergency pericardiocentesis is shown. At a diagnostic pericardiocentesis when there is a big exudate, try to remove as much as possible liquid. Sometimes for drainage of a cavity of a pericardium in it on a needle establish a small vascular catheter.
