Cardiac Tamponade Cardiac Tamponade is a life-threatening complicationn caused by accumulation of fluid in the pericardium.

This fluid, which can be blood, pus or air in the pericardial sac, accumulates fast enough and in sufficient quantity to compress the heart and restrict blood flow in and out of the ventricles. This is a cardiac emergency. Large or rapidly accumulating effusions raise the intrapericardial pressure to a point at which venous blood flow cannot flow into the heart, whihc decreases ventricular filling. As a result, venous pressure rises and cardiac output and arterial blood pressure fall. A narrowing pulse pressure signals cardiac tamponade. The heart attempts to compensate by beating rapidly (tachycardia), but tachycardia cannot sustain cardiac output for long. Prompt intervention is necessary to prevent schock and death. Hypotension, tachycardia, jugular venous distention, cyanosis of lips and nails, dyspnea, muffled heart sounds, diaphoresis, and paradoxical pulse are present. The client may be comfortable and quiet in one minute and then restless with a feeling of impending doom. Clinical manifestations include elevated venous pressure, distended neck veins, Kussmaul's sign, hypotension, narrowed pulse pressure, tachycardia, dyspnea, restlessness, anxiety, cyanosis of lips and nails, diaphoresis, muffled heart sounds, pulsus paradoxus, decreased friction rub, decreased QRS voltage and electrical alternans.