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Tamponade is when fluid builds up in the sac around the heart and squeezes it, so it cannot fill and pump properly. In cancer the fluid usually comes from cancer cells in the sac. Breathlessness is the main symptom, and the fluid is drained with a needle or a small operation.
NCI PDQ (Cardiopulmonary Syndromes) explains that tamponade results from progressive fluid accumulation in the pericardial sac, raising intrapericardial pressure and lowering diastolic filling, stroke volume and cardiac output. Haemodynamic compromise occurs when the normal 15 to 50 mL of pericardial fluid rises to 200 to 1,800 mL, though as little as 250 mL can cause tamponade if it gathers quickly. Signs include tachycardia, pulsus paradoxus, raised jugular venous pressure and hypotension, and echocardiography shows chamber compression. PDQ reports malignant pericardial effusions in up to 21% of people with cancer and that half of cases present with tamponade; lung cancer is the commonest cause in men and breast cancer in women.
In a 2024 systematic review of 41 published patients with malignant pericardial effusion, dyspnoea was the leading symptom (90%), tamponade was present in 78%, and pericardiocentesis or a pericardial window was performed in 98%.
Showing the technology this term belongs to: Cardio-oncology.
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