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Iatrogenic Causes of Cardiac Tamponade Resulting From Surgical Procedures: An Overview
Ahmed K Alsenan1, Hassan N Al Dhneem1, Hussain A Alfandi1
1Department of Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU.
Insights
Cardiac tamponade, a life-threatening emergency, impairs heart function due to fluid buildup. Preventing diagnostic and treatment errors in surgical patients is crucial to reduce cardiac tamponade incidence and mortality.
Area of Science:
- Cardiology
- Medical Emergencies
- Surgical Safety
Background:
- Cardiac tamponade is a critical condition where pericardial effusion impairs cardiac function.
- Accumulation of fluid in the pericardial sac can result from trauma, malignancy, uremia, and surgical procedures.
- Iatrogenic causes are significant, particularly in patients undergoing cardiac and non-cardiac surgeries.
Purpose of the Study:
- To highlight the life-threatening nature of cardiac tamponade.
- To identify errors in diagnosis and treatment associated with various procedures.
- To emphasize the need for error prevention in surgical settings.
Main Methods:
- Review of medical literature and case reports concerning cardiac tamponade.
- Analysis of iatrogenic causes and medicolegal aspects.
- Identification of risk factors and contributing human factors in healthcare settings.
Main Results:
- Numerous diagnostic and treatment errors are linked to cardiac tamponade during surgical procedures.
- Patients on anticoagulants or anticancer drugs face increased risk.
- Factors like misdiagnosis, delayed treatment, and human errors contribute to adverse outcomes.
Conclusions:
- Most iatrogenic cardiac tamponade cases are preventable.
- Enhanced preoperative screening and meticulous surgical practices are essential.
- Reducing incidence and mortality requires a focus on precision, caution, and error mitigation.
Abstract:
Cardiac tamponade is one of the most severely life-threatening emergencies encountered, mainly because of its significant impact on the pumping capacity of the heart by compressing the cardiac chambers due to the rapid accumulation of blood, fluid, pus, or clots in the pericardial sac. These accumulations may be collected following traumas, malignancies, uremia, and many other medical conditions as well as surgical procedures. Numerous errors and medicolegal aspects have been identified in diagnosing and treating cardiac tamponade associated with cardiac-related procedures such as valve replacement surgeries, cardiac pacemaker implantation, pericardiocentesis, and other non-cardiac related procedures such as peri-hiatal surgeries. Patients taking anticoagulants or anticancer medications are especially susceptible to developing cardiac tamponade when undergoing surgical procedures, raising the question of preoperative screening to avoid errors. Misdiagnosis, treatment delay or failure to deliver the utmost quality of treatment, lack of complication screening and follow-ups for those at risk, surgeons rushing to complete cases, burnout, and other human factors are predispositions to the development of cardiac tamponade. Fortunately, most of these errors occurring within healthcare settings are avoidable and must be prevented for eliminating any risks to reduce the incidence and mortality of cardiac tamponade cases resulting from iatrogenic etiology. It is an intricate condition where precision and caution are crucial.
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