Imaging Findings in Cardiac Tamponade with Emphasis on CT

Abstract

Cardiac tamponade is a life-threatening condition that results from slow or rapid heart compression secondary to accumulation of fluid, pus, blood, gas, or tissue within the pericardial cavity. This condition can be associated with multiple causes including trauma, inflammation, scarring, or neoplastic involvement of the pericardial space among others. The main pathophysiologic event leading to tamponade is an increase in intrapericardial pressure sufficient to compress the heart with resultant hemodynamic impairment, which leads to limited cardiac inflow, decreased stroke volume, and reduced blood pressure. These events result in diminished cardiac output, which manifests clinically as a distinctive form of cardiogenic shock. Although cardiac tamponade is a clinical diagnosis, imaging studies play an important role in assessment and possible therapeutic intervention. Computed tomographic (CT) findings associated with cardiac tamponade include pericardial effusion, usually large, with distention of the superior and inferior venae cavae; reflux of contrast material into the azygos vein and inferior vena cava; deformity and compression of the cardiac chambers and other intrapericardial structures; and angulation or bowing of the interventricular septum. Familiarity with the clinical and pathophysiologic features of cardiac tamponade and correlation with the associated CT findings are essential for early and accurate diagnosis.

Study of etiological and clinical profile of pericardial effusion in a tertiary care hospital in Kosi region of Bihar, India

“…Mild pericardial effusion consider when echo free space is > 10 mm by M-mode echocardiography while the moderate effusions were defined as an echofree space of anterior plus posterior pericardial spaces of 10-20 mm during diastole, and severe effusions as a sum of echo-free spaces > 20 mm. 9,10 In developed countries the different study show the following results such as commonest cause of pericardial effusion is neoplastc, idiopathic and uremic, but less common cause is infectious, collegen vascular disease and post MI.…”

A Curious Case of Pericardiohydroptysis

“…The progression or natural course of pericardial rupture is not known and hence the optimal management not defined [14]. The case is unique as idiopathic pericarditis and pericardial effusion has been associated with pericardial tamponade as a common complication in most series and not pericardial rupture [15].…”

Medical image of the week: pericardial effusion in a setting of bacterial endocarditis

“…Chest radiographs are often unreliable in depicting pericardial effusions, as they require at least 200 mL of pericardial fluid to portray an enlarged cardiomediastinal silhouette (1). As fluid continues to accumulate in the pericardial space, the increase in pericardial pressure on the chambers can eventually lead to cardiac tamponade-a form of cardiogenic shock (2).…”