Hemopericardium - accumulation of blood in the pericardial cavity. Depending on the causes of the appearance of blood in the pericardium, traumatic and non-traumatic hemopericardis are distinguished. Traumatic hemopericardium occurs with wounds and closed injuries of the heart, after heart surgery, and can also be observed as a complication of cardiac puncture, pericardium, or catheterization of the heart cavities. Non-traumatic hemopericardium develops as a result of heart rupture due to myocardial infarction or rupture of an aortic aneurysm inside the pericardial cavity.
The clinical picture depends on the amount of blood pericardium poured into the cavity. If it does not exceed 200 ml, hemopericardium is almost asymptomatic; if the amount of accumulated blood is more than 400 ml, the condition becomes life-threatening. The rapid accumulation of fluid in the pericardial cavity - cardiac tamponade - limits the filling of the ventricles during diastole and leads to a decrease in cardiac output. The main symptoms of cardiac tamponade are tachycardia , small pulse , decrease in blood pressure, increased venous pressure, shortness of breath , cyanosis , swelling of the neck veins. During auscultation, there is a deafness of heart tones, during X-ray examination there is an increasing increase in the size of the heart shadow, smoothness of the arcs, on an ECG - a decrease in the voltage of the teeth. More accurately set the amount of fluid in the pericardium allows echocardiography.
If hemopericardium is suspected, immediate hospitalization of the patient to the surgical department is indicated, where pericardiocentesis is performed during the development of cardiac tamponade — fluid is evacuated from the pericardial cavity.