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Beck’s Triad

By July 10, 2019 No Comments
Understanding Beck’s Triad

Becks triad is a set of symptoms related to pericardial tamponade. There are three symptoms. They are:

1. Raised jugular venous pressure
2. The sound of the heartbeat being muffled
3. Low blood pressure (which can also be narrow blood pressure and weak pulse)

Jugular venous pressure, or JVP, is the specific blood pressure over the veins covering the jugular area. This is, of course, the area in the lower neck toward the front of the body. This area extends down the neck underneath the chin.

Raised jugular venous pressure combined with low blood pressure or a weak pulse means that the overall blood pressure is different from that near the jugular area. The drastic difference between this specific blood pressure and the overall blood pressure can cause numerous health problems and can lead to shock and death.

Combined with a muffled heartbeat, these symptoms often indicate pericardial tamponade, although the symptoms can be included in the symptoms of other conditions as well. As you may suspect, the symptoms belie that there is something covering the heart area. This is what causes the muffled heart sounds and odd change in blood pressure above the heart.

In the case of pericardial tamponade, which is often what is diagnosed if a patient only has Beck’s Triad (not combined with multiple other symptoms), the muffling comes from inflammation. If the patient has the three symptoms and is diagnosed with pericardial tamponade, they will have fluid (blood and inflammatory fluid) in the sac that covers the heart and the roots of the great vessels. This fluid causes problems with the ventricles in the heart. It compromises the ability of the heart to properly regulate blood flow, even if the arteries are functioning properly. Consequently, the jugular venous blood pressure becomes dysfunctional and will raise. However, due to the blockage, the overall blood pressure will drop.

The condition is very similar to having a clogged garden hose. Near the clog, the pressure is higher, but the actual water flow in the hose is too low. Just like having a rock in your garden hose, these three symptoms combined can cause a lot of problems. Left untreated, the symptoms can lead to problems with other organs and tissues within the body. They can also cause swelling in the lungs, shock, and death.

There are several things that can cause pericardial tamponade, which will go along with the symptoms of Becks Triad. Anything that may puncture the pericardial wall is a likely culprit. They are dangerous in and of themselves, so if someone has the symptoms of the triad, they are definitely in an emergency state. Things like cancer, a broken catheter, a heart attack, kidney failure, hypothyroidism, radiation to the chest, blunt trauma to the chest, lupus, an aneurysm, or an infection relating to the heart all have the potential to puncture the double-walled sac that covers the heart.

The triad of symptoms indicate an emergency for which a person must be stabilized immediately. The doctor will place the patient in a monitored state and drain the fluid from the sac in order to relieve the pressure. In some cases, clots will have to be removed. In even rarer cases, the doctor will have to remove part of the sac that covers the heart. In all cases, the patient will be placed on fluids and medications as well.

Of course, the second part of treatment is to determine the underlying cause of the swelling and to treat that. In cases like kidney failure or hypothyroidism, treatment can be a long and complicated process. In cases like an aneurysm or heart attack, treatment may be simpler if the patient can be stabilized by changing their environment and prescribing them medications.

Beck’s Triad three symptoms are diagnosed by a doctor, but people may notice a few other serious symptoms if they have the triad. They should see a doctor if they have other symptoms which accompany the triad. The symptoms include weakness, pain that can be relieved by leaning forward, anxiety and restlessness, low blood pressure, trouble breathing along with rapid breathing, radiating chest pain, fainting, dizziness, or loss of consciousness.

When a patient is admitted with these symptoms (which can be similar to the symptoms of heart attack and aneurysm), the doctor should check for the triad. If the triad appears, the patient should undergo a few other diagnostic treatments to see if pericardial tamponade is the culprit. Some of the diagnostic treatments to expand on the presence of the triad and determine its cause include an echocardiogram (ultrasound of the heart), X-rays, a thoracic CT scan, a magnetic resonance angiogram, or an electrocardiogram. These things are all directed at assessing the condition and swelling related to the patient’s heart or heartbeat. After one or more of these diagnostic treatments, the doctor will be able to assess the diagnoses underlying the triad.

Beck’s three symptoms are also related to congestive heart failure. The accompanying symptoms include coughing, fatigue, and water retention. The most usual occurrence of congestive heart failure is called left-sided congestive heart failure, and it causes the three Beck’s symptoms to appear. What usually happens is that the left ventricle of the heart does one of two things. It either stops contracting normally, which is called systolic failure. The blood pressure becomes low, and the heart fails to pump blood at a sustainable rate. Alternatively, diastolic failure occurs when the left ventricle becomes stiff. This causes the heart to lose blood pressure, because it cannot fill with enough blood during rest.

Right-sided congestive heart failure can also occur, which will cause the lungs to lose blood. This will cause blood to back up in the vessels, which will in turn cause fluid retention in dangerous places such as the vital organs.

Congestive heart failure has four stages. The first stage usually has few symptoms that are noticeable to the average patient unless they are engaged in especially active behavior.

More advanced congestive heart failure at stage two will alert the patient with symptoms, such as fatigue and palpitations, during normal activity.

At stage three, mild exercise will cause fatigue and palpitations. The patient may not be uncomfortable during rest, but they will be unable to carry out mild activities.

At stage four, palpitations and fatigue may occur even at rest.

So, if you see these symptoms in you or another person, it is wise to get to the doctor quickly and get assessed for Beck’s Triad three telltale signs. The cause is likely to be either pericardial tamponade or congestive heart failure. Medication is usually necessary for both issues, and surgery is required for pericardial tamponade. Dramatic lifestyle changes are usually required to treat congestive heart failure.

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