Bovis ISSN 2398-2993

Cardiac tamponade

Synonym(s): pericardial disease

Contributor(s): Louise Cox-O’Shea, Vetstream Ltd , Gayle Hallowell

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Introduction

  • Cause:
    • Most common primary cause is foreign body penetration of the reticulum -> diaphragm -> pericardium resulting in bacterial pericarditis.
    • Can also be idiopathic or secondary to cardiac/pericardial neoplasms, particularly lymphoma, right-sided heart failure, hypoproteinemia, trauma, infections.
  • Signs:
    • Acute: cardiac tamponade and collapse.
    • Chronic: right-sided heart failure or congestive heart failure.
  • Diagnosis: electrocardiography, ultrasonography.
  • Treatment: depends on cause - but treatment options usually limited and slaughter the most likely option.
  • Prognosis: poor.

Pathogenesis

Etiology

  • In cattle the most common cause is penetration of the pericardium (and resulting infection) from reticular foreign body Traumatic reticulitis which has migrated cranially penetrating first the diaphragm then the pericardium.
  • Hematogenous spread of infection (such as pasteurellosis, salmonellosis Salmonellosis etc).
  • Cardiac neoplasia (lymposarcoma is the most common cardiac tumor in cattle), idiopathic inflammatory disease, trauma.

Pathophysiology

  • Pericardial disease → gradual accumulation of pericardial fluid → impaired diastolic function (compliance failure) → decreased end-diastolic volumes → poor cardiac output → sympathetic nervous system and renin-angiotensin-aldosterone system activation → tachycardia, vasoconstriction, retention of sodium and water → increased end-diastolic pressures in atria → increased ventricular filling pressures → backward heart failure → right side more susceptible (thinner walled) → increased central venous pressure (distended jugular veins, hepatic venous congestion, ascites, pleural effusion).
  • With acute pericardial effusion, compensatory mechanisms are unable to respond to the sudden decrease in cardiac output, resulting in precipitous output failure and collapse.
  •  With chronic cases, effusive pericarditis involves fibrin deposition, this leads to a fibrinous pericarditis. Fibrosis of the pericardium can in turn lead to a restrictive pericarditis.

Timecourse

  • Insidious subclinical course and progressive edema with chronic disease.
  • Acute presentation: may result from hemorrhage (left atrial rupture, ruptured neoplasm, and trauma).

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Alcott C J, Howard J, Wong D & Haynes J (2013) Fibrinous pericarditis and cardiac tamponade in a 3-week-old pony foal. Equine Vet Educ 25 (7), 328-333 VetMedResource.
  • Reimer J (2013) Management of equine pericarditis. Equine Vet Educ 25 (7), 334-338.
  • Athar H, Parrah J, Moulvi B A, Singh M & Dedmari F H (2012) Pericarditis in Bovines- A Review  International Journal of Advanced Veterinary Science and Technology 2012 1 (1), 19-27.
  • U Braun (2008) Traumatic pericarditis in cattle: Clinical, radiographic and ultrasonographic findings. The Veterinary Journal 182 (2), 176–186 PubMed.
  • Worth L T & Reed V B (1998) Pericarditis in horses, 18 cases (1986-1995). JAVMA 212 (2), 248 PubMed.
  • Freestone J F, Thomas W P, Carlson G P & Brumbaugh G W (1987) Idiopathic effusive pericarditis with tamponade in the horse. Equine Vet J 19 (1), 38-42 PubMed.

Other sources of information

  •  Merck Veterinary Manual.


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