Ten questions regarding cardiac tamponade

Cardiac tamponade is a pericardial syndrome characterized by diastolic impairment due to the accumulation of pericardial fluid under pressure. It may be an acute life-threatening condition if not recognized and treated (e.g. cardiac tamponade by hemopericardium), or may present as a subacute condition allowing in some cases a delayed treatment. The causes of cardiac tamponade are the same as for pericardial effusion, primarily cancer in one third of cases (being lung cancer the most common type of cancer), bacterial infections (25% of cases), iatrogenic factors (15% of cases), and acute aortic disease with aortic dissection. Cardiac tamponade is reported in <1% of cases of myocardial infarction and is mainly due to heart rupture, or more rarely to hemorrhagic evolution of post-myocardial infarction pericarditis. Cardiac tamponade is a clinical diagnosis that is confirmed by echocardiography. The risk of recurrent cardiac tamponade is around 10% at 10-year follow-up and is mainly determined by the underlying etiology, with cancer patients showing the highest mortality. In this focused review, we will try to provide answers to the most common questions on the causes, presentation, diagnosis, treatment, and outcomes of cardiac tamponade.