Pericardial effusion and cardiac tamponade. Are they the same thing?

[Ezekiel20]

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Dear all

Just had this question come to my mind, and I could email my lecturers but they are probably on holiday given the time of the year..

So my question is, what is the difference between pericardial effusion and cardiac tamponade?

Stedmans's Medical Dictionary (27th ed) states:

- pericardial effusion: increased fluid within the pericardial sac; can cause circulatory compromise by compression of the heart; most often caused by inflammation, infection, malignancy, and uremia

- cardiac tamponade: compression of the heart due to critically increased volume of fluid in the pericardium.

The two definitions sound the same to me. But most dictionaries have separate entries for the two terms, and do not link to each other. Even emedicine.com has separate articles on each.

Can somebody clear this up for me?

Thanks

 

[DropkickMurphy]

The difference is the presence of impairment of hemodynamics by the presence of the fluid in the pericardial space.

 

[liveandlearn]

The difference is the presence of impairment of hemodynamics by the presence of the fluid in the pericardial space.

to clarify this for you..

cardiac tamponade typically impairs the function of the heart.

pericardial effusion is the exudation of fluid from the vessels into the potential space around the heart.

You can have pericardial effusion without tamponade.. and in the same respect, you can tamponade anything. note the root word. (tampon). It simply means to stop flow by either plugging or constricting.

 

[Ezekiel20]

So we're saying that perdicardial effusion can lead to cardiac tamponade, but it doesn't have to.. right?

Makes more sense now.. Thanks to both of you

 

[Antiviral22]

So we're saying that perdicardial effusion can lead to cardiac tamponade, but it doesn't have to.. right?

Makes more sense now.. Thanks to both of you

I agree with everyone's response (pericardial effusion can lead to tamponade), but I was under the impression that tamponade was the electrocardiographic finding of the severe effusion that was impairing the heart output. Am I of base on this one? Just curious.

 

[liveandlearn]

antiviral.. Im not completely qualified to answer this but here's what i do know.

pericarditis and resulting pericardial effusion can present on EKG as a depressed PR segment, low voltage QRS, and elevated ST segment. I think the low voltage QRS is what you are refering to. In short, the QRS is the ventricles contracting, if they are contracting less forcefully than is normal physiologically the voltage is low. This could be evidence of impaired filling, or a restrictive cause of congestive heart failure such as tamponade.

The term tamponade itself is simply refering to the fact that the effusion is restricting the blood flow through the heart. I am not 100% sure what the "gold standard" is in diagnosing tamponade but it is generally diagnosed by a constelation of symptoms that include pulsus paradoxus (a drop in systolic blood pressure greater than 10mm on inspiration), distant heart sounds on auscultation, and a "balloon like heart" as evident on chest x ray. It is also a great diagnosis to make after you do a pericardiocentesis and the symptoms are relieved. ;-)

hope this helps.

 

[Hawkeye Kid]

tamponade has little/nothing to do with EKG changes, save for the fact that you may see electrical alternans in a pt with tamponade (but certainly don't have to). as stated previously, CARDIAC tamponade (like liveandlearn said, you can tamponade anything) is hemodyamic compromise secondary to the heart's inability to fill due to the fact that it's compressed by fluid in the pericardial sac. this can be due to trauma or any condition that causes trans/exudation of fluid into the space.

 

[UCLA2000]

Please remember that cardiac tampanade can be caused by things such as trauma. When I hear pericardial effusion, pericarditis pops into my head. Cancer etc. some sort of medical process.

 

[liveandlearn]

When I hear pericardial effusion, pericarditis pops into my head. Cancer etc. some sort of medical process.

yeah.. by the way the pnomonic i like to use for remember the etiology of pericarditis is. STUDNV

SLE, TB, Uremia, Drugs, neoplasm, virus (as always, viral being the most common)

just thought id share that with you guys... it helps me remember because im full of STUD NV.. ;-)