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Table 54.1

Causes of Cardiac Tamponade

Bleeding into the pericardial space

Penetrating and blunt chest trauma, including external cardiac compression

Bleeding from a cardiac chamber or coronary artery caused by perforation or laceration as a complication of cardiac catheterization, percutaneous coronary intervention, pacemaker insertion, pericardiocentesis or central venous cannulation

Bleeding after cardiac surgery

Cardiac rupture after myocardial infarction

Aortic dissection with retrograde extension into pericardial space

Anticoagulant therapy for atrial fibrillation or other indication in the presence of pericarditis

Thrombolytic therapy given (inappropriately) for pericarditis

Serous or sero-sanguinous pericardial effusion

Neoplastic involvement of the pericardium (most commonly in carcinoma of breast or bronchus, or lymphoma or cardiac angiosarcoma)

Pericarditis complicating connective tissue diseases (e.g. systemic lupus erythematosus, rheumatoid arthritis)

Postcardiotomy syndrome

Tuberculous and viral pericarditis

Uraemic pericarditis

Idiopathic pericarditis (tamponade is a rare complication)

Purulent pericarditis

Pyogenic bacterial infection, usually due to spread of intrathoracic infection, for example following thoracic surgery or trauma, or complicating bacterial pneumonia