Study note

Pericardial effusion: imaging, electrical alternans and aspiration

THE CONTEXT

Investigations establish the presence of pericardial effusion, assess its effect on cardiac function and may provide fluid for diagnosis.

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Definitive investigation: Echocardiography is the definitive investigation for pericardial effusion.

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Monitoring: It helps assess the size of the effusion and its effect on cardiac function.

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QRS voltage: QRS voltages are often reduced in the presence of a large effusion.

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Electrical alternans: QRS complexes may alternate in amplitude because the heart moves to and fro within the fluid-filled pericardial sac.

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Cardiac silhouette: Chest X-ray may show an enlarged cardiac silhouette, which has a globular appearance when the effusion is large.

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Diagnostic use: Aspiration of the effusion may be required for diagnostic purposes.

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Therapeutic use: Aspiration may also be necessary to treat a large effusion.

NEETx

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