Causes

Numerous causes can cause unusual fluid accumulation in the pericardium. The nature of the fluid in question can provide important clues to the underlying disease. Clear or turbid fluids, pus or blood may be present.

Important causes of acute pericardial tamponades are injuries to the heart. These can be externally inflicted injuries such as shots, stitches or surgical and medical interventions. Injuries without external influence such as rupture of blood vessels or tears due to high blood pressure, ventilation, as well as acute illnesses such as heart attacks or a collapsed lung can also cause bleeding into the pericardium.

Cloudy or purulent effusions, on the other hand, can be attributed to infections or malignant diseases of the thorax. These are usually less acute and slower progressing clinical pictures. The increasing effusion in the pericardium leads to pressure on the heart muscle via various mechanisms and a restriction of its function, which disrupts the supply of blood to the organs and can lead to numerous, fatal complications.

A heart attack is a frequent cause of pericardial tamponade. Pericardial tamponade, however, is one of the most dangerous complications of a heart attack. The mechanism that causes a heart attack is a blockage of a coronary artery, which causes a certain area of the heart muscle that was supplied by the blocked artery to be cut off from the blood supply.

The sudden lack of oxygen causes the heart muscle cells to die, making the tissue fragile, brittle and able to die. The heart muscle may rupture immediately or later as a result of high pressure or medical intervention, causing the pericardium to suddenly fill with blood and compress the heart from the outside. Aortic dissection is itself a highly acute and life-threatening clinical picture, in which a tear in the inner vascular wall of the aorta, the main artery, occurs.

The aorta leaves the heart at the top, turns downwards in the aortic arch and runs through the thorax and abdomen towards the pelvis. In its course, the inner vessel wall can rupture acutely, causing blood to flow into the muscles of the aorta and causing severe circulatory problems. The danger of a rupture of the aorta is particularly threatening, allowing blood to flow into the thorax, abdomen or pericardium in a very short time and causing numerous other symptoms in addition to a severe blood deficiency. Pericardial tamponade is a dangerous complication of aortic dissection, which has an additional negative effect on heart function and blood flow in the body, often with a fatal outcome.