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| − | == Introduction ==
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| − | Cardiac tamponade is compression of the heart. It develops when the intrapericardial pressure increases due to unchecked fluid accumulation within the pericardial sac. As the pericardium is fibrous and inelastic this fluid creates a compression on the heart. Intrapericardial compression leads to diastolic collapse of the right atrium and sometimes the right ventricle, decreased ventricular filling and a resultant decrease in cardiac output. This will lead to arterial hypotension.
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| − | Compensatorty mechanisms are activated by the failing heart and include the sympathetic nervous system and the [[Renin Angiotensin Aldosterone System|renin-angiotensin-aldosterone system]].
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| − | Causes of cardiac tamponade include all pericardial diseases such as [[Traumatic Pericarditis|traumatic reticulitis- pericarditis]] in cattle, fibrinous pericarditis in pigs in [[Glasser's Disease|'Glassers disease']] and [[hydropericardium]] due to congestive [[:Category:Heart Failure|heart failure]] or [[Mulberry Heart Disease|mulberry heart disease]] in pigs. Sudden causes of cardiac tamponade and death occur in haemopericardium due to rupture of the intrapericardial section of the aorta. This occurs in horses spontaneously or in pigs due to [[Copper Deficiency|copper deficiency]].
| + | Cardiac tamponade develops when the intrapericardial pressure increases due to unchecked fluid accumulation within the pericardial sac. As the pericardium is fibrous and inelastic this fluid creates a compression on the heart. Intrapericardial compression leads to diastolic collapse of the right atrium and sometimes the right ventricle, decreased ventricular filling and a resultant decrease in cardiac output. This will lead to arterial hypotension. |
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| + | Compensatorty mechanisms are activated by the failing heart and include: |
| | + | *Sympathetic nervous system. |
| | + | *Renin-angiotensin-aldosterone system. |
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| − | == Clinical Signs ==
| + | ''Clinical Signs'' are predominantly those of right sided heart failure as the right chambers have thinner walls and so are more greatly affected by the raised intrapericardial pressure. |
| − | Clinical Signs are predominantly those of [[Heart Failure, Right-Sided|right sided heart failure]] as the right chambers have thinner walls and so are more greatly affected by the raised intrapericardial pressure. | + | Clinical signs will include; ascites, hepatomegaly, splenomegaly, hepato-jugular reflux and venous distension due to raised central venous pressure etc. |
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| − | Signs will also include ascites, hepatomegaly, splenomegaly, hepato-jugular reflux and venous distension due to raised central venous pressure etc. In severe circumstances sudden death may occur without previous clinical signs.
| + | Heart sounds are muffled or seem distant and a sinus tachycardia may be present. |
| − | | + | Arterial pulses will be weak. |
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| + | '''Pulsus paradoxus''': An exagerrated decline in arterial pulse pressure during inspiration, typical of a pericardial effusion. |
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| − | == Diagnosis ==
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| − | On auscultation, heart sounds are muffled or seem distant and a sinus tachycardia may be present. Arterial pulses will be weak and there may be presence of '''pulsus paradoxus''', which is an exaggerated decline in arterial pulse pressure during inspiration, typical of a pericardial effusion.
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| − | Ultrasonography of the heart will reveal fluid in the pericardial sac and compression of the cardiac chambers.
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| − | Post mortem examination in cases of sudden death due to cardiac tamponade will reveal blood in the pericardial sac.
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| − | == Treatment and Control ==
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| − | Treatment is to reduce compression immediately by pericardial drainage.
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| − | == References ==
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| − | Andrews, A.H, Blowey, R.W, Boyd, H and Eddy, R.G. (2004) '''Bovine Medicine '''(Second edition), ''Blackwell Publishing''.
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| − | Cowart, R.P. and Casteel, S.W. (2001) '''An Outline of Swine diseases: a handbook,''''' Wiley-Blackwell''.
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| − | Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat''' Volume 2 (Fifth Edition),'' W.B. Saunders Company''.
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| − | Fossum, T. W. et. al. (2007)''' Small Animal Surgery''' (Third Edition), ''Mosby Elsevier''.
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| − | {{review}}
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| | [[Category:Pericardial_Pathology]] | | [[Category:Pericardial_Pathology]] |
| − | [[Category:Expert_Review]]
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| − | [[Category:Cardiology Section]]
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Cardiac tamponade develops when the intrapericardial pressure increases due to unchecked fluid accumulation within the pericardial sac. As the pericardium is fibrous and inelastic this fluid creates a compression on the heart. Intrapericardial compression leads to diastolic collapse of the right atrium and sometimes the right ventricle, decreased ventricular filling and a resultant decrease in cardiac output. This will lead to arterial hypotension.
Compensatorty mechanisms are activated by the failing heart and include:
- Sympathetic nervous system.
- Renin-angiotensin-aldosterone system.
Clinical Signs are predominantly those of right sided heart failure as the right chambers have thinner walls and so are more greatly affected by the raised intrapericardial pressure.
Clinical signs will include; ascites, hepatomegaly, splenomegaly, hepato-jugular reflux and venous distension due to raised central venous pressure etc.
Heart sounds are muffled or seem distant and a sinus tachycardia may be present.
Arterial pulses will be weak.
Pulsus paradoxus: An exagerrated decline in arterial pulse pressure during inspiration, typical of a pericardial effusion.