What is the Difference Between Cardiac Tamponade and Constrictive Pericarditis

Cardiac tamponade and constrictive pericarditis are clinical problems involving the potential space surrounding the heart or pericardium. The pericardium is a fluid-filled sac that surrounds and protects the heart. Apart from that, the heart wall is made up of three layers: epicardium, myocardium, and endocardium.

The key difference between cardiac tamponade and constrictive pericarditis is their cause. Cardiac tamponade occurs when the fluid sac around the heart fills with too much blood or other fluid, while constrictive pericarditis occurs when the pericardium of the heart becomes stiffer and thicker than normal.

CONTENTS

1. Overview and Key Difference
2. What is Cardiac Tamponade  
3. What is Constrictive Pericarditis
4. Similarities – Cardiac Tamponade and Constrictive Pericarditis
5. Cardiac Tamponade vs Constrictive Pericarditis in Tabular Form
6. Summary – Cardiac Tamponade vs Constrictive Pericarditis
7. FAQ – Cardiac Tamponade and Constrictive Pericarditis

What is Cardiac Tamponade?

Cardiac tamponade is due to too much fluid filling in the fluid sac that surrounds the heart, which puts more pressure on the heart. This ultimately prevents heart chambers from filling properly. The symptoms of this condition may include sharp chest pain, trouble breathing, changes in skin colour, heart palpitation, fast pulse, and altered mental status. Cardiac tamponade can be caused by several causes, such as blunt trauma, advanced cancer, aortic dissection, heart attack, tuberculosis, infection or inflammation of the pericardium, heart cancer, heart or kidney failure, and hypothyroidism.

Figure 01: Cardiac Tamponade

Cardiac tamponade can be diagnosed through physical examination, echocardiogram, chest X-ray, CT scan, electrocardiogram, and heart catheterization. Furthermore, cardiac tamponade is treated by using a needle (pericardiocentesis) or performing surgery such as thoracotomy.

What is Constrictive Pericarditis?

Constrictive pericarditis is a condition where the pericardium surrounding and protecting the heart becomes too stiff or thick. The symptoms of constrictive pericarditis may include shortness of breath, chest pain, fatigue, dizziness, swelling, loss of muscle mass, loss of appetite, and feeling full. Constructive pericarditis can happen due to several reasons, such as infection, heart and circulatory problems, immune system conditions, inflammatory disorders, heart surgery, radiation therapy, cancer, and for unknown reasons.

Figure 02: Constrictive Pericarditis

Constructive pericarditis can be diagnosed through medical history, physical examination, blood test, echocardiogram, electrocardiogram, chest X-ray, CT scan, MRI, left and right heart catheterization. Furthermore, constructive pericarditis is treated through surgery (pericardiectomy) and medications for underlying causes.

Similarities Between Cardiac Tamponade and Constrictive Pericarditis

1. Cardiac tamponade and constrictive pericarditis are two heart conditions.
2. Both conditions can cause similar symptoms, such as chest pain, shortness of breath, and fatigue.
3. Both conditions can be diagnosed through physical examination and imaging scans.
4. They can be treated through medications and surgery.

Difference Between Cardiac Tamponade and Constrictive Pericarditis

Definition

• Cardiac tamponade is a condition that takes place when abnormal amounts of fluid accumulate in the pericardial sac, which compresses the heart.
• Constrictive pericarditis is a condition that occurs when the pericardium becomes thickened and scarred.

Causes

• Cardiac tamponade is caused by gunshots or stab wounds, blunt trauma, accidental perforation, cancer, aortic aneurysm, pericarditis, lupus, high levels of radiation to the chest, hypothyroidism, heart attack, kidney failure, and infection.
• Constrictive pericarditis is caused by infection, heart surgery, radiation therapy, cancer, tuberculosis.

Symptoms of Infection

• Symptoms of cardiac tamponade include anxiety, low blood pressure, weakness, chest pain, trouble breathing, rapid breathing, discomfort that is relieved by sitting or leaning forward, fainting, dizziness, and loss of consciousness.
• Symptoms of constrictive pericarditis include breathing difficulties, fatigue, a swollen abdomen, chronic, severe swelling in legs and ankles, weakness, lower-grade fever, and chest pain.

Diagnosis

• Cardiac tamponade can be diagnosed by physical symptoms evaluation, CT scan, ultrasound, magnetic resonance angiogram, and electrocardiogram.
• Constrictive pericarditis can be diagnosed by physical symptoms evaluation, blood test, CT scan, X-ray, MRI, cardiac catheterization, electrocardiogram, and echocardiogram.

Treatment

• Cardiac tamponade can be treated with pericardiocentesis and thoracotomy.
• Constrictive pericarditis can be treated with taking water pills, taking pain medications, decreasing activity levels, decreasing the salt amount in the diet, taking counter-inflammatory drugs such as ibuprofen, taking colchicine, taking corticosteroids, and surgeries like pericardiectomy.

The following table summarizes the difference between cardiac tamponade and constrictive pericarditis.

Summary – Cardiac Tamponade vs Constrictive Pericarditis

Cardiac tamponade and constrictive pericarditis are two heart diseases. Cardiac tamponade is characterized by abnormal fluid accumulation in the pericardial sac compressing the heart, while constrictive pericarditis is a condition characterized by a thickened, fibrotic pericardium. This is the basic difference between cardiac tamponade and constrictive pericarditis.

FAQ: Cardiac Tamponade and Constrictive Pericarditis

1. What causes a cardiac tamponade?

• Cardiac tamponade is a condition that involves the compression of the heart due to blood or fluid accumulation in the space called the pericardium sac. This can be caused by gunshots or stab wounds, blunt trauma, accidental perforation, cancer, aortic aneurysm, pericarditis, lupus, high levels of radiation to the chest, hypothyroidism, etc.

2. How do you diagnose cardiac tamponade?

• Echocardiogram is the best choice to help make the diagnosis of cardiac tamponade. Other test may include physical examination, CT scan, ultrasound, and magnetic resonance angiogram.

3. What is the immediate management of cardiac tamponade?

• The most common procedure to treat cardiac tamponade is pericardiocentesis. In this condition, a needle and a long, thin tube are used to remove the fluid. Other treatments may include surgeries like thoracotomy.

4. What is the main cause of constrictive pericarditis?

• Constrictive pericarditis can happen due to infection, tuberculosis, heart and circulatory problems, immune system conditions, inflammatory disorders, heart surgery, radiation therapy, and cancer. It may also occur due to unknown reasons.

5. What is the best treatment for constructive pericarditis?

• Constructive pericarditis is treated by taking water pills, anti-inflammatory medicine such as colchicine, antibiotics, drugs such as ibuprofen, corticosteroids, and surgeries like pericardiectomy.

Reference:

1. Holland, Kimberly. “Constrictive Pericarditis: Symptoms, Causes, and Treatment.” Healthline, Healthline Media.
2. “Under Pressure: Cardiac Tamponade.” Cleveland Clinic.

Image Courtesy:

1. “Pericarditis can progress to pericardial effusion and eventually cardiac tamponade” By Scientific Animations (CC BY-SA 4.0) via Commons Wikimedia

2. “Constrictive pericarditis” By علاء – Own work (CC BY-SA 4.0) via Commons Wikimedia

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