When this compression occurs, there is a decrease of blood flow both to and away from the heart. The relatively non-elastic pericardium can normally hold 25cc's of fluid. Any excess amount of fluid prevents the ventricles from filling sufficiently. An acceptable cardiac output may be maintained for a short period of time. Eventually, the compensatory mechanisms will be defeated, and hypotensive shock and total circulatory collapse will occur.
Cardiac tamponade can occur from both blunt and penetrating chest injury.
Immediate treatment involves needle aspiration of the fluid from the pericardium, or pericardiocentesis. Once this treatment is complete, the surgical creation of a pericardial window to relieve fluid accumulation and prevent further accumulation is required. The injury must be repaired promptly. Myocardial Contusion Myocardial contusion is primarily a diagnosis of autopsy rather than one devised in the emergency room. More often, the healthcare practitioner needs to diagnose a risk for myocardial contusion, rather than the actual contusion itself.