Cardiac tamponade is a form of cardiogenic shock which is caused by fluid accumulation in the pericardial space.
The fluid which is either blood or a large pericardial effusion, increases the pericardial pressure and inhibits venous return.
Reduced venous return results in reduced cardiac output, hypotension and shock.
The degree of cardiovascular compromise depends on the rate of fluid accumulation; 2 litres of pericardial fluid may not cause symptoms if the accumulation is slow whereas much smaller volumes may be fatal if the accumulation is acute.
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