Pericardial Effusion / Tamponade Pulmonary / Respiratory Emergencies

Pericardial Effusion occurs when excess fluid accumulates in the pericardium, the sac around the heart. Small effusions might not cause symptoms, but if the fluid builds up rapidly or in large amounts, it can compress the heart and limit its function—this is called cardiac tamponade.

Cardiac tamponade is a medical emergency that can lead to shock, organ failure, or death without immediate treatment. It interferes with the heart’s ability to fill and pump properly, causing a dramatic drop in blood pressure and organ perfusion.

Causes:

• Infections (viral, bacterial, tuberculosis)
• Trauma or surgery
• Cancer
• Autoimmune conditions
• Uremia (from kidney failure)
• Post-heart attack (Dressler’s syndrome)

Symptoms:

• Shortness of breath
• Chest pain or pressure
• Fatigue
• Lightheadedness
• Rapid heartbeat
• Enlarged neck veins (JVD)
• Low blood pressure
• Muffled heart sounds (classic tamponade sign)

Diagnosis:

• Echocardiogram (main diagnostic tool)
• Chest X-ray
• ECG
• CT/MRI (in complex cases)

Treatment:

• Emergency pericardiocentesis (draining fluid with a needle)
• Surgical pericardial window (creating a hole in the pericardium)
• Treating underlying cause (infection, cancer, etc.)