Tamponade in the cardiac context (cardiac tamponade) is a life-threatening emergency in which fluid accumulates within the pericardial sac surrounding the heart, building up sufficient pressure to compress the heart chambers and prevent them from filling with blood. This significantly reduces cardiac output and can rapidly cause cardiovascular collapse and cardiac arrest.
The pericardial sac normally contains only a very small amount of lubricating fluid. When fluid accumulates (from trauma, cancer, pericarditis, aortic dissection, or as a complication of cardiac procedures), even relatively small additional volumes can dramatically increase intrapericardial pressure.
Cardiac tamponade produces Beck’s triad: falling blood pressure, raised jugular venous pressure, and muffled heart sounds. It is one of the 4T reversible causes of cardiac arrest in the ALS framework (alongside Tension pneumothorax, Thrombosis, and Toxins). Treatment is immediate pericardiocentesis (needle drainage of the pericardial fluid), which can be life-saving within minutes.
For a full description of the condition, investigations, and treatment, see the comprehensive Cardiac Tamponade entry.
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