Acute Cardiac Tamponade

The pericardium is a membrane surrounding the heart. It comprises an outer fibrous pericardium and an inner double-layered serous pericardium. Serous pericardium includes visceral layer and parietal layers, separated by the pericardial cavity containing 15 to 50 ml of plasma ultra-filtrate in healthy people. The pericardium mechanically protects the heart and reduces friction between the heart.[1][2] Pericardial diseases present as acute or chronic pericarditis, pericardial effusion, and cardiac tamponade. Pericarditis is a common disorder caused by inflammation of the pericardium. Acute pericarditis was reported in 5% of patients admitted to the emergency department[1] and 0.1% to 0.2% of hospitalized patients[2] for non-ischemic chest pain. Pericarditis can be divided into non-constructive and constrictive pericarditis. Pericarditis is commonly associated with pericardial effusion that can sometimes worsen to cardiac tamponade. Cardiac tamponade is a grave condition that happens after sudden and/or excessive accumulation of fluid in the pericardial space. The state restricts the appropriate filling of the cardiac chambers, disturbing normal hemodynamics, and ultimately causing hypotension and cardiac arrest.[3][4] This article reviews the etiology, signs and symptoms, diagnosis, and management of pericarditis and cardiac tamponade.