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Pericardial effusion

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Title: Pericardial effusion  
Author: World Heritage Encyclopedia
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Subject: Acute pericarditis, Ewart's sign, Hemopericardium, Osborn wave, List of eponymously named medical signs
Collection: Cardiac Dysrhythmia, Disorders of Fascia, Pericardial Disorders
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Pericardial effusion

Pericardial effusion
A 2D transthoracic Echocardiogram of pericaridal effusion. The Swinging Heart
Classification and external resources
Specialty Cardiac surgery
ICD-10 I30, I31.3
ICD-9-CM 423.9
DiseasesDB 2128
eMedicine med/1786
MeSH D010490

Pericardial effusion ("fluid around the heart") is an abnormal accumulation of fluid in the pericardial cavity. Because of the limited amount of space in the pericardial cavity, fluid accumulation leads to an increased intrapericardial pressure which can negatively affect heart function. A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. Pericardial effusion usually results from a disturbed equilibrium between the production and re-absorption of pericardial fluid, or from a structural abnormality that allows fluid to enter the pericardial cavity.

Normal levels of pericardial fluid are from 15 to 50 mL.

Contents

  • Signs and symptoms 1
  • Causes 2
  • Diagnosis 3
  • Treatment 4
  • References 5
  • External links 6

Signs and symptoms

Chest pain or pressure are common symptoms. A small effusion may be asymptomatic. Larger effusions may cause cardiac tamponade, a life-threatening complication; signs of impending tamponade include dyspnea, low blood pressure, and distant heart sounds.

The so-called "water-bottle heart" is a radiographic sign of pericardial effusion, in which the cardiopericardial silhouette is enlarged and assumes the shape of a flask or water bottle.

It can be associated with dullness to percussion over the left subscapular area due to compression of the left lung base. This phenomenon is known as Ewart's sign.[1]

Causes

Diagnosis

Water bottle-shaped heart
Sinus tachycardia with low QRS voltage and QRS alternans

It may be:


Treatment

Treatment depends on the underlying cause and the severity of the heart impairment. Pericardial effusion due to a viral infection usually goes away within a few weeks without treatment. Some pericardial effusions remain small and never need treatment. If the pericardial effusion is due to a condition such as lupus, treatment with anti-inflammatory medications may help. If the effusion is compromising heart function and causing cardiac tamponade, it will need to be drained, most commonly by a needle inserted through the chest wall and into the pericardial space called pericardiocentesis. A drainage tube is often left in place for several days. In some cases, surgical drainage may be required by cutting through the pericardium creating a pericardial window.

References

  1. ^ "Pericardial Disease". 
  2. ^ [2]
  3. ^ Pericardial effusion:What are the symptoms?, Dr. Martha Grogan M.D.

External links

  • Pericardial Disease Cleveland Clinic Online Medical Reference
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