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Pathology
Fluid within the pericardium which restricts ventricular filling and cardiac output
Aetiology
Transudate: Congestive cardiac failure, myxoedema, nephrotic syndrome
Exudate: TB, empyema
Haemorrhagic: Trauma, aneurysmal rupture
Malignant: Fluid from metastasis
Signs
Tachycardia, pulsus paradoxus
Symptoms
Chest pain, shortness of breath, fatigue may be asymptomatic
Investigations
ECG: low QRS voltage, electrical alternans (beat-to-beat shift in QRS/P waves)
CXR: enlarged cardiac silhouette
ECHO: specific and sensitive method of detecting a pericardial effusion
Treatment
Monitor, pericardiocentesis.
Prognosis
Depends on underlying cause. Large effusion indicate more serious disease.
Pericardial effusions may progress to cardiac tamponade
Key Facts
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Key Images
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Key References
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