Hemopericardium: Causes, Symptoms, and Treatment

hemopericardium icd 10

It refers to a deadly condition that consists of blood infiltrating into the pericardium.

Hemopericardium is an accumulation of blood in the pericardial cavity of the heart. This condition can lead to cardiac tamponade, and that can be deadly to patients if they don’t get it treated as soon as possible.

In the same vein, a massive hemopericardium can cause acute heart failure which could kill the patient if left untreated.

To understand where this condition begins some people need to know what is the Pericardium, also known as Pericardial Sac.

The Pericardium is a double-walled sac that surrounds the heart and the roots of the great vessels.

Hemopericardium occurs when pure blood fills the pericardial cavity, a space between the fibrous and serous layers of the pericardium. The result is a remarkable volume of blood compressing the tissue of the heart.

This condition can affect both children and adults, but only grown-ups tend to develop cardiac tamponade when affected by Hemopericardium.


Medical experts usually divide the events and factors that could potentially produce Hemopericardium into two categories: traumatic and non-traumatic.

Traumatic factors

Some causes of this disease are related to external factors, such as the ones listed below:

  • Closed or open lesions on the chest
  • A wound on the pericardial cavity of the heart
  • Damage to large blood vessels
  • Complications of surgeries to the heart or the blood vessels
  • Not following standard safety measures during a catheter angiography
  • A puncture-biopsy which went wrong
  • Misuse of stitches/sutures after a procedure
  • An ablation procedure through a catheter that went wrong
  • Performing surgery with implants while the patient suffers from heart arrhythmia
  • Complications from an intracardiac injection

These are many of the events and circumstances that could potentially cause the wound or lesion that produces Hemopericardium.

However, people can take damage to their pericardium through other kinds of situations. For example, a bullet-wound or getting stabbed can cause the injuries responsible for this condition.

In other circumstances, people get this kind of wound during accidents such as landslides, earthquakes, and flooding.

It can even happen to any person whenever they’re at home or work just for disregarding their very own safety.

Non-traumatic factors

In some cases when the cause of Hemopericardium is something internal, rather than an event based on patients’ surroundings and actions.

The cause of the bleeding that fills the pericardial sac could be a rupture of the coronary arteries or some blood vessels. This pathology is plausible in the context of the following diseases:

  • Myocardial Infarction, also known as Heart Attack
  • Inherited Coagulation Disorders
  • Pericardial Cysts
  • Inflammatory Cardiomyopathy, also known as Myocarditis
  • Haemorrhagic Diathesis
  • An Aortic Aneurysm
  • Angiosarcoma
  • Myocardial Abscess

However, most of the cases of Hemopericardium occur because of traumatic factors.

Hemopericardium Symptoms

The clinical manifestation of this condition tends to vary from case to case. It will depend on the amount of blood filling the pericardium.

If the blood volume is low, then patients will rarely display any noticeable symptom. In fact, this health issue usually manifests itself when the blood volume reaches approximately 150 ml.

When such thing happens, the heart’s tissues get compressed by the high amount of blood filling the pericardial cavity, which alters the blood flow and diminishes the cardiac output.

Sometimes, Hemopericardium compresses the coronary arteries, hampering the flow of blood to the myocardium. In such cases, a patient could end up developing Acute Limb Ischemia.

Some symptoms of Hemopericardium are pretty similar to a Cardiac Tamponade: difficult breathing, nausea, high levels of anxiety/stress, excessive sweating, weakness, etc.

However, the signs inherent to Hemopericardium would be the following:

  • Low blood pressure
  • Slow heart rate
  • Weak pulse
  • Cyanosis
  • Fainting
  • Abnormal heart sounds

Hemopericardium Treatment

Medical experts may prescribe Enoxaparin Sodium (brand name: Lovenox) or Dabigatran Etexilate (brand name: Pradaxa) while putting the patient into a Warfarin therapy.

The most typical treatment to deal with this condition is pericardiocentesis, a medical procedure that consists of a pericardial puncture to remove the fluid from the pericardium.

Doctors insert an 18-gauge needle between the xiphoid process and the left costal margin until reaching the pericardial cavity to drain the blood from the sac.

Sometimes, healthcare providers may leave a catheter in the pericardial sac to continue draining all the remains after the initial procedure.