Cardiac tamponade natural history

Overview
Cardiac tamponade is a life-threatening condition requiring urgent intervention to remove the pericardial fluid. Complications include pulmonary edema, cardiac failure, cardiogenic shock and ultimately death.

Cardiac tamponade has a good prognosis if detected early and treated immediately. Short-term survival is mostly dependent on early diagnosis and relief of tamponade. Long-term survival depends upon the prognosis of the underlying cause, irrespective of the mode of treatment.

Natural History and Complications
Cardiac tamponade is a life-threatening condition requiring urgent intervention to remove the fluid from the pericardial cavity. If untreated, patient may develop following complications:
 * Pulmonary edema due to decreased forward flow of blood from left ventricle and increased pressures within the pulmonary vasculature.
 * Cardiac failure secondary to inadequate ventricular filling and cardiac output.
 * Cardiogenic shock
 * Death

Prognosis

 * Prognosis is good with early recognition and management of the condition and the underlying cause of the tamponade. 3.2% of total deaths, over a 10-year period, were attributable to cardiac tamponade in a postmortem study of 14,368 patients in County of Cornwall, UK between 1995 and 2004 and was mostly attributed to rupture of an acute myocardial infarction or intrapericardial rupture of a dissecting ascending aortic aneurysm.
 * Cardiac tamponade caused by central venous catheters had a mortality rate of 77% before 1980 and 47% between 1980-1989.


 * Patients with underlying malignancy has the highest rate of mortality . Short-term survival is mostly dependent on early diagnosis and relief of tamponade. Long-term survival depends upon the prognosis of the underlying cause, irrespective of the mode of treatment.


 * Tamponade secondary to idiopathic effusion and penetrating chest wounds, has been shown to be associated with better outcomes with emergent removal of pericardial fluid.