DRG Category: 315
Mean LOS: 4.5 days
Description MEDICAL: Other Circulatory System Diagnoses with CC
Acute cardiac tamponade is a sudden accumulation of fluid in the pericardial sac leading to an increase in the intrapericardial pressure. The pericardial sac surrounds the heart and normally contains only 10 to 20 mL of serous fluid. The sudden accumulation of more fluid (as little as 200 mL of fluid or blood) compresses the heart and coronary arteries, compromising diastolic filling and systolic emptying and diminishing oxygen supply. The end result is decreased oxygen delivery and poor tissue perfusion to all organs.
The incidence of cardiac tamponade in the United States is 2 cases per 10,000 population, and approximately 2% of penetrating injuries lead to cardiac tamponade. It is a potentially life-threatening condition, needing emergency assessment and immediate interventions. Some patients develop a more slowly accumulating tamponade that collects over weeks and months. If the fibrous pericardium gradually has time to stretch, the pericardial space can accommodate as much as 1 to 2 L of fluid before the patient becomes acutely symptomatic. Three phases of hemodynamic changes occur with acute cardiac tamponade (Table 2). Complications include decreased ventricular filling, decreased cardiac output, cardiogenic shock, and death.
Phases of Cardiac Tamponade
|Phase 1||Accumulation of pericardial fluid leads to increased ventricular stiffness, which requires a higher filling pressure; left and right ventricular filling pressures are higher than the intrapericardial pressure during this phase|
|Phase 2||As fluid accumulates, pericardial pressure increases above the ventricular filling pressure; cardiac output thereby is reduced|
|Phase 3||Decrease in cardiac output continues due to equilibration of pericardial and left ventricular filling pressures|
Cardiac Tamponade has been found in Diseases and Disorders
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