Talk:Cardiac tamponade

How

How can heart rupture usually happen if it is very uncommon?

Grammar: although uncommon, the most plausible site of cardiac rupture is in a scar resulting from myocardial infarction. JFW | T@lk 00:21, 16 February 2006 (UTC)

Beefing up the article

I've just done a bit of a re-write, wikifying the language/layout, adding some references etc. I have to admit I was quite surprised when I saw how underdeveloped the article is: I'll be expanding the article more over the coming days/weeks, but if anybody else has any suggestions or wants to jump in then feel free. In particular, I think we could do with some statistics on survival/morbidity rates for different presentations (for example, the reference I put in for now, on futility of pericardiocentesis for unwitnessed arrest due to tamponade, for example, comes from the Oxford Handbook of pre-hospital care, which, whilst a commonly used text, does not provide hard statistics): if anybody would like to point me towards a decent research study on this, that would be very nice! --John24601 19:57, 24 April 2007 (UTC)

Good work on this article. Just a note, though. When you mention that some prehospital care providers have facilities to provide pericardiocentesis, you say "but this is generally futile if the patient has already suffered a cardiac arrest before arrival of the healthcare professional to undertake the procedure". I doubt EMS will ever be providing pericardiocentesis during a full-arrest...so it's not really a concern...ever. Perhaps saying that if EMS can get to patient before cardiac arrest, some providers are authorized to provide the procedure. Just a thought and sharing how I read it. -Anthony —Preceding unsigned comment added by 72.87.212.127 (talk) 19:34, 1 July 2008 (UTC)

Compartment Syndrome?

My physiology professor lists pericardial tamponade as a compartment syndrome, but I cannot seem to find any references to this connection. Anyone? 85.178.51.102 (talk) 23:46, 5 January 2008 (UTC) It's called a "compartment syndrome" because the pericardial fluid builds rapidly in the paricardial cavity. —Preceding unsigned comment added by 70.90.78.225 (talk) 16:27, 5 May 2011 (UTC)

Steroid use???

Can you get this from taking steroids?, or any of the other things/drinks that high school footballers/athletes take? I know a guy who died of this at age 29, and I always wondered about how he looked so beefy, even from his high school days. Thanks in advance to anybody that knows. If steroid use (or those other things that high school athletes take) can cause this, maybe put it in???? —Preceding unsigned comment added by 86.173.34.157 (talk) 20:33, 11 January 2010 (UTC)

Picture

This article needs a better header image. The image provided is of poor quality, and does not convey tamponade physiology. The outline of the myocardium is bad, and while a trained eye could identify the large pericardial effusion, its hardly useful for those who know little on the subject (the users for whom the page is most useful). A better image will show a collapsed right ventricle with a clear outline of heart, and possibly arrows for the caption to identify the features of a heart in tamponade. I will try to muster one up. If anyone has an image to contribute, it shouldn't be hard to improve upon this one. — Preceding unsigned comment added by 167.171.195.39 (talk) 09:30, 21 August 2011 (UTC)

Dispute on some edits:

Doc_James I moved this to the Cardiac Tamponade Talk page. I finally was able to "tag" you here, as it wasn't working before with the "space" inbetween your username. Seeing how this is a bit of a dispute, it should be discussed here. The following was our discussion on the topic.

1)Pericardial rub, as I had explained in my removal of the term, is not a clinical sign of cardiac tamponade. It is a sign of pericarditis. If a patient has cardiac tamponade due to pericarditis, they might have pericardial rub. But patients who have cardiac tamponade due to other causes will not have rub. It is never considered a sign of cardiac tamponade, itself, rather pericardtis. Please provide sources that state otherwise since you had put it back in the article.

"A pericardial friction rub, while not common, can also be heard in cardiac tamponade if the underlying cause is an inflammatory pericarditis." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2878263/

2)MI (Heart attack) is a common cause of cardiac tamponade, which is why I included it. https://www.merckmanuals.com/home/injuries-and-poisoning/chest-injuries/cardiac-tamponade https://www.cedars-sinai.org/health-library/diseases-and-conditions/c/cardiac-tamponade.html

3)Cardiac tamponade is considered a medical emergency, which is why I put that in the lead. You removed it without explanation?

4)I included the term Beck's triad in the lead because the signs were already listed there, except your addition of pericardial rub. The term is famous for cardiac tamponade so I included it there.

5)Pericarditis and pericardial effusion are common cardiac complications of systemic lupus erythematosus (SLE), which can lead to cardiac tamponade, hence my reason for including Lupus.

I look forward to your feedback. Also, I tried to address you on the talk page there, but it said your user name did not exist? I tried using 'DocJames', please let me know what to type when addressing you! Thanks. Battykin (talk) 17:45, 30 April 2020 (UTC)

       (3) That it is a medical emergency does not need to go in the first sentence. The first sentence should describe what it is.
       (2) The source that was present did not describe MI as a common cause. With the Merck source we can move to one of the most common causes.
       (4) the name of the triad is in the body of the article already
       (5) source does not list tampnade as a common cause of SLE Doc James (talk · contribs · email) 05:18, 1 May 2020 (UTC)'

       User:Battykin 1) The NEJM review article states "Contrary to common belief, a pericardial rub is a frequent finding in patients with inflammatory effusions"[1] So I am not sure what is incorrect with mentioning it? Doc James (talk · contribs · email) 08:58, 1 May 2020 (UTC)

In response to your replies:

1)The source you linked, does not state pericardial rub is a sign of cardiac tamponade. It states the same thing I have said already. It's a sign of pericarditis (inflammation). IF a patient has pericardial rub with cardiac tamponade, that is how the physician makes a conclusion of pericarditis + cardiac tamponade present. It's important to make the distinction. This article is about cardiac tamponade, and the signs should be what is seen in cardiac tamponade, itself. The causes are already listed, so whatever signs are present within those causes might also appear in the patient, which is a given. Also, the source you put here is from 2003. If you believe pericardial rub is a sign of tamponade, you should be able to find reliable sources that actually state that. It's used as a sign for pericarditis, which is not tamponade.

2)The sources I left you above DOES in fact list MI as a common cause of cardiac tamponade, and as a doctor, myself, I can tell you that it is generally accepted as one, and is listed in multiple books and journals. When you remove something like that and state it's not "common", you should provide a source saying it's "rare" or "uncommon" instead of just reverting the edit.

3) Part of describing what a condition is, would be using terms like "chronic, hereditary, life-threatening condition, hence medical emergency. I feel this should be in the lead as to tell the reader what it is. It's still describing the condition which goes in hand with it being an emergency condition. It is what separates it from just a mild pericardial effusion.

4)I am fine with not mentioning the name of the triad and leaving it in the body, but my reason for putting it there was because the signs were mentioned there, and that is what those signs are collectively called.

5)Please see my previous edit again, and my comment above. Lupus is a common autoimmune cause of cardiac tamponade, not the other way around.

Perhaps this should be discussed here before either one of us make changes. Other experts of this topic would be appreciated as well. Thanks. Battykin (talk) 20:04, 1 May 2020 (UTC)

User:Battykin

(1) Yah agree the pericardial rub should be clarified.

(2) This ref, which was what was their originally did not state it was a common cause just that it was a cause.[1] The new ref does state that so moved it and add the ref you provided.

(3) Okay added to the treatment section of the lead.

(4) Sure and added.

(5) Which ref says autoimmune diseases are a common cause of tamponade? The ref above mentions them but not that they are common. Doc James (talk · contribs · email) 06:22, 2 May 2020 (UTC)

Doc_James Looks great. Thanks for clarifying the pericardial rub in the article. I just wanted it to be clear to readers, that it's not a Dx sign of tamponade by itself. Great working with you :) Battykin (talk) 21:59, 2 May 2020 (UTC)

An effusion is common enough in autoimmune diseases, but tamponade is uncommon. UpToDate, a tertiary source, is specific that tamponade is rare [2]. MartinezMD (talk) 06:42, 2 May 2020 (UTC)

MartinezMD Yes, you are correct. Let me clarify what I was saying. Lupus is a common auttoimmune disease that can lead to cardiac tamponade. There are many autoimmune diseases, but Lupus and RA are the ones more common to lead to tamponade, even if tamponade is rare. Hope that makes more sense. Thanks for your reply. Battykin (talk) 21:59, 2 May 2020 (UTC)

Extrinsic Cardiac compression

@Battykin@Doc James@John24601 @MartinezMD

I've attempted to do a literature review to create a new article, or edit Cardiac tamponade, however, I'm unable to find a predefined name for the condition that I describe below.

There are a number of conditions, many transient in nature which cause similar distress to tamponade that arise from another organ filling the paracardial cavity and placing compression on the heart; thus reducing the hearts ability to fill. Examples: Hiatal Hernia, Sliding Hiatal Hernia, Esophageal impaction all can result in a reduced stroke volume. As the pericardium is a type of serosa layer, even a severe case of pleurisy, or infection in the potential space between the the pericardium and pleural layers would have a detrimental effect. Finally, I haven't found any literature, but I supposed even a substantially swollen thymus might reduce the hearts stroke volume in the right set of conditions.

Does anybody know a defined clinical name for this panacea of conditions that effect cardiac stroke volume so we can create a space for it on an article, or dedicate a new article to it?eximo (talk) 18:57, 18 March 2024 (UTC)

It sounds like you are looking for Obstructive shock. I don't think an esophageal impaction would do it as it would perforate long before expanding to the point of affecting cardiac output, but I get your point. MartinezMD (talk) 22:17, 18 March 2024 (UTC)

@MartinezMD that looks correct. I linked things up, thanks! eximo (talk) 00:41, 19 March 2024 (UTC)

Did a number of updates to the lead of obstructive shock at mdwiki a while back. Agree that is the condition you are looking for.

https://mdwiki.org/wiki/Obstructive_shock Doc James (talk · contribs · email) 03:05, 19 March 2024 (UTC)