Incidence and characteristics of dysphoria in patients with cardiac tamponade

BackgroundThe signs and symptoms associated with cardiac tamponade are often nonspecific. Dysphoria associated with cardiac tamponade has been understudied. An understanding of the behavioral traits associated with dysphoria and cardiac tamponade may contribute to early detection.ObjectivesThe behavioral traits of dysphoric patients with cardiac tamponade are described.MethodsA retrospective chart review of 56 adult patients with a diagnosis of cardiac tamponade from 1990 to 1999 at a university hospital in Japan is described.ResultsThe incidence of dysphoria associated with cardiac tamponade was 17 of 66 events (25.8%) in 56 adult Japanese patients. The most frequent behavioral traits were “body movement,” “facial expression,” “gets up/tries to get up,” and “restlessness.” Statements of “somewhat/something strange” and “no place to put (my) body” were documented twice for each category. Subjects verbalized that they were going to “die” in four events.ConclusionClinicians caring for patients at risk of cardiac tamponade are advised to be sensitive to the patients’ restless body movements and unusual facial expressions, and statements indicating restlessness and impending death.