Hemoperricardium refers to blood in the pericardial sac of the heart. 



It is clinically similar to a pericardial effusion.



It may cause  cardiac tamponade.



It can be caused by necrosis of the myocardium after myocardial infarction, chest trauma, and by anticoagulants.



Other causes of hemoparicardium include ruptured aneurysm of sinus of Valsalva and other aneurysms of the aortic arch.



Chest trauma, free wall rupture after a myocardial infarction, bleeding into the pericardial sac following a type A aortic dissection, and as a complication of invasive cardiac procedures are other causes of hemopericardium.



Acute leukemia and anticoagulants can lead to hemopericardium.



It can be identified with a chest X-ray or a chest ultrasound.



Commonly treated with pericardiocentesis.



Hemopericardium can lead to cardiac tamponade, a condition that is fatal if left untreated.



Symptoms associated with hemopericardium: difficult and rapid breathing, fatigue chest pressure and have an abnormally elevated heart rate.




Hemopericardium typically begins with blood accumulating in the pericardial sac posterior to the heart, and eventually expands to surround the entire heart.



Accumulated fluid causes pressure within the pericardial sac to increase, and compression of the adjacent cardiac chambers can occur: cardiac tamponade



Cardiac tamponade, is often associated with hemopericardium and can be fatal if not diagnosed and treated promptly.



Early signs of cardiac tamponade compression include right atrial inversion during ventricular systole followed by diastolic compression of the right ventricular outflow tract.



Diagnosis of hemopericardium is recognized by chest X-ray showing a large heart, and echocardiography.



Clinical findings include tachycardia, jugular venous distension, low blood pressure, and pulsus paradoxus.



It is usually treated by pericardiocentesis.



Pericardiocentesis refers to the placement of a needle in the pericardial sac to remove fluid.



Procedure typically utilizes a needle that is inserted between the xiphoid process and the left costal margin until it enters the pericardial sac, when it can then be used to drain the fluid from the sac.



A catheter is often left in the pericardium to continue draining any remaining fluid after the initial procedure.



A cardiac tamponade study indicated 13.3% fatality of cases in which it was not caused by a malignant disease.


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