What is the Difference Between Tension Pneumothorax and Cardiac Tamponade

The key difference between tension pneumothorax and cardiac tamponade is that tension pneumothorax is caused by the continuous flowing and trapping of air in the pleural space of the lungs, while cardiac tamponade is caused by the filling of the fluid sac around the heart by blood and other fluids, compressing the heart.

Tension pneumothorax and cardiac tamponade are two life-threatening conditions. Both these conditions can be present when the body is in a critical status, like chest trauma and obstructive shock. Therefore, tension pneumothorax and cardiac tamponade should be immediately treated by a specialist in the emergency care unit. Excessive pressure develops around your lungs due to tension pneumothorax, while cardiac tamponade puts pressure on your heart.

CONTENTS

1. Overview and Key Difference
2. What is Tension Pneumothorax 
3. What is Cardiac Tamponade
4. Similarities – Tension Pneumothorax and Cardiac Tamponade
5. Tension Pneumothorax vs Cardiac Tamponade in Tabular Form
6. Summary – Tension Pneumothorax vs Cardiac Tamponade

What is Tension Pneumothorax?

Tension pneumothorax is a serious condition that happens when there is a continuous entrance and entrapment of air in the pleural space of the lungs. As a result, it compresses the lungs, heart, blood vessels, and other structures in the chest. The accumulated air puts pressure on the lung and prevents it from expanding properly. Ultimately, this leads to respiratory distress. As the air continues to accumulate in the trachea, other structures push away from pneumothorax, which causes difficulty in breathing as well. The signs and symptoms of this condition include shortness of breath, acute chest pain, reduced blood pressure, blood oxygen, heart rate, and altered mental status. Tension pneumothorax can be caused without a known reason or by underlying lung diseases and any kind of trauma (like traumatic chest injury), including complications from medical procedures.

Tension pneumothorax can be diagnosed through physical examination, chest X-ray, blood test, and ultrasound. Available treatment options for this condition may include administering high-concentration supplemental oxygen, needle decompression of the chest, and placing a chest tube to facilitate the relief of the remaining air.

What is Cardiac Tamponade?

Cardiac tamponade is a life-threatening condition caused by the filling of blood and other fluids in the fluid sacs around the heart. This puts pressure on the heart. Because of the pressure, the heart cannot fill up with blood, and ultimately it reduces the amount of blood that the heart can pump. This condition can be caused by trauma, medical conditions like advanced cancer, heart attack, tuberculosis, inflammation of the pericardium, inflammatory diseases like lupus, rheumatoid arthritis, heart or kidney failure, hypothyroidism, surgery to heart, usage of catheter-based procedures, placement of devices like pacemakers and radiation therapy near the heart. The symptoms of this condition may include sharp pain in the chest, trouble breathing, fainting, dizziness or light-headedness, changes in the skin colour, heart palpitation, fast pulse, jaundice, altered mental status, swelling in the abdomen or legs, and chest discomfort.

Moreover, cardiac tamponade can be diagnosed through physical examination, echocardiogram, chest X-ray, CT scan, electrocardiogram, and heart catheterization. Pericardiocentesis and surgery are two treatment options for cardiac tamponade.

What are the Similarities Between Tension Pneumothorax and Cardiac Tamponade?

• Tension pneumothorax and cardiac tamponade are two life-threatening conditions.
• Both these conditions can be seen when the body is in a critical state, like chest trauma and obstructive shock.
• They may have similar symptoms like difficulty breathing, low blood pressure, altered mental status, etc.
• Both these conditions can be diagnosed through physical examination and imaging tests.
• They are mainly treated through specific medications and surgeries.

What is the Difference Between Tension Pneumothorax and Cardiac Tamponade?

Tension pneumothorax is a life-threatening condition that occurs due to the accumulation of air in the pleural space of the lung, while cardiac tamponade is a life-threatening condition that occurs due to the filling of fluid sacs around the heart by blood and other fluids. Thus, this is the key difference between tension pneumothorax and cardiac tamponade. Furthermore, tension pneumothorax may happen due to an unknown reason, underlying lung diseases, and any kind of trauma (like traumatic chest injury), including complications from medical procedures. On the other hand, cardiac tamponade may happen due to trauma, medical conditions like advanced cancer, heart attack, tuberculosis, inflammation of the pericardium, inflammatory diseases like lupus, rheumatoid arthritis, heart or kidney failure, hypothyroidism, surgery to heart, usage of catheter-based procedures, placement of devices like pacemakers and radiation therapy near the heart.

The below infographic presents the differences between tension pneumothorax and cardiac tamponade in tabular form for side-by-side comparison.

Summary – Tension Pneumothorax vs Cardiac Tamponade

Tension pneumothorax and cardiac tamponade are two life-threatening conditions that can be present with critical status like chest trauma. Both conditions need urgent management for life-saving. Tension pneumothorax happens due to the continuous entrance of air into the pleural space of the lungs. In contrast, cardiac tamponade happens due to the accumulation of blood and other fluids in the fluid sacs around the heart. So, this summarizes the difference between tension pneumothorax and cardiac tamponade.

Reference:

1. Weiser, Thomas G. “Pneumothorax (Tension) – Injuries; Poisoning.” MSD Manual Professional Edition, MSD Manuals.
2. “Cardiac Tamponade: Causes, Symptoms & Treatment.” Cleveland Clinic.

Image Courtesy:

1. “Tensionpneumo” By James Heilman, MD – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Pericarditis can progress to pericardial effusion and eventually cardiac tamponade” By Scientific Animations (CC BY-SA 4.0) via Commons Wikimedia