Materiały źródłowe

• #1 Pericardial Effusion: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17351-pericardial-effusion

  Pericardial effusion is a buildup of fluid in the space around your heart. It can happen for many reasons, like infections, injuries or other medical conditions. If the buildup is severe or happens quickly, it can compress your heart and cause a life-threatening medical emergency. […] You may not have any pericardial effusion symptoms with a mild case. Symptoms are more likely when an effusion happens quickly, involves a large amount of fluid or causes cardiac tamponade. The main symptoms of pericardial effusions and cardiac tamponade include: Shortness of breath (dyspnea). Chest pressure or pain. Fast heartbeat or heart palpitations. Lightheadedness or dizziness. Fainting (syncope). Fatigue. Anxiety, confusion or other behavior changes (because of low blood flow to your brain). Cyanosis (a blue or gray tinge to your lips or under your fingernails that happens when you have low blood oxygen levels).

• #1 Pericardial Effusion Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/157325-clinical

  Cardiovascular symptoms in pericardial effusion can include the following: […] Chest pain, pressure, discomfort – Characteristically, pericardial pain may be relieved by sitting up and leaning forward and is intensified by lying supine. […] Light-headedness, syncope […] Palpitations. […] Respiratory symptoms can include the following: […] Cough […] Dyspnea […] Hoarseness. […] Neurologic symptoms of pericardial effusion can include anxiety and confusion, while hiccoughs may occur as a gastrointestinal (GI) symptom. […] Classic Beck triad of pericardial tamponade – Hypotension, muffled heart sounds, jugular venous distention. […] Pulsus paradoxus – Exaggeration of physiologic respiratory variation in systemic blood pressure, defined as a decrease in systolic blood pressure of more than 10mm Hg with inspiration, signaling falling cardiac output during inspiration.

• #1 Pericardial Effusion: Causes, Symptoms, Diagnosis & Treatment

  https://www.webmd.com/heart-disease/pericardial-effusion

  You may or may not have symptoms. You’re less likely to have symptoms if the effusion is small or develops slowly. […] Symptoms may include: Chest pressure or pain that may reach your arm, back, neck, or shoulder, or get worse when you breathe deeply, lie flat, or cough. Heart palpitations (a sensation that your heart is racing, pounding, fluttering, or skipping a beat) or a fast heartbeat. Shortness of breath. Dizziness, faintness, or lightheadedness. Fatigue. Altered mental status, such as confusion or agitation. Skin color changes, such as a blue or gray color to your lips or under your fingernails. Swelling in your belly and legs. Fever if you have an infection or inflammation. […] If effusion is large enough, it can put pressure on your surrounding tissues or nerves, which may cause symptoms such as: Trouble swallowing (dysphagia). Hiccups. Coughing or hoarseness. […] You are more likely to have symptoms when the effusion is large, develops quickly, or leads to cardiac tamponade. A pericardial effusion that develops into cardiac tamponade is a medical emergency and may be life-threatening.

• #1 UC San Diego Health Health Library | San Diego Hospital, Healthcare

  https://myhealth.ucsd.edu/Library/Encyclopedia/134,566

  You may not have any symptoms. This is more often the case with a mild effusion. You might be more likely to have symptoms from whatever is causing the pericardial effusion. For example, you might have fever if you have an infection of the pericardial sac. […] When effusion is more severe, you may have symptoms such as: Chest pain or discomfort, Enlargement of the veins of the neck, Fainting, Fast breathing, Increased heart rate, Nausea, Pain in the right upper abdomen, Shortness of breath, Swelling in the arms and legs. […] If the effusion is very severe, it can also lead to very low blood pressure. This can cause symptoms of shock. These include: Lightheadedness or dizziness, Cool arms and legs, Clammy skin, Weakness, Rapid breathing, Nausea or vomiting, Pale skin, Less urine output. […] Symptoms often improve greatly after the excess fluid is drained. The outcome of treatment may depend on the cause and severity of the condition, how quickly treatment is started, and your overall health.

• #1 Pericardial Effusion: Causes, Symptoms and Treatment | Doctor

  https://patient.info/doctor/pericardial-effusion

  The symptoms produced by a pericardial effusion depend on the speed with which the effusion is formed, as well as the size of the effusion. Many small-to-moderate effusions formed over a long period of time will be relatively asymptomatic. However, even small effusions which have occurred rapidly may compromise the circulation and cause tamponade. […] Chest pain, pressure, discomfort: pericardial pain may be relieved by sitting up and leaning forward and is intensified by lying supine. […] Light-headedness, syncope. […] Palpitations. […] Cough, shortness of breath, hoarseness. […] Anxiety and confusion. […] Hiccoughs. […] Classic triad of pericardial tamponade: hypotension, muffled heart sounds, jugular venous distention. […] Pulsus paradoxus: exaggeration of the normal respiratory variation in systemic blood pressure (defined as a decrease in systolic blood pressure of more than 10 mm Hg with inspiration). A pulsus paradoxus in patients with a pericardial effusion helps distinguish those with cardiac tamponade from those without.

• #1 Pericardial effusion – Wikipedia

  https://en.wikipedia.org/wiki/Pericardial_effusion

  Non-cardiac symptoms may also present due to the enlarging pericardial effusion compressing nearby structures. Some examples are nausea and abdominal fullness, dysphagia and hiccups, due to compression of stomach, esophagus, and phrenic nerve respectively. […] A pericardial effusion with enough pressure to adversely affect heart function is called cardiac tamponade. […] Pericardial effusions can cause cardiac tamponade in acute settings with fluid as little as 150mL. In chronic settings, however, fluid can accumulate anywhere up to 2L before an effusion causes cardiac tamponade.

• #1 Pericardial Effusion – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431089/

  Pericardial effusion is diagnosed using a combination of clinical evaluation and imaging techniques, with echocardiography being the primary method for confirming the presence of fluid around the heart. Symptoms may include chest pain and dyspnea, with electrocardiography and additional imaging providing supportive information. […] In patients with pericardial effusion due to pericarditis, patients often present with chest pain and dyspnea, with symptoms improving while sitting upright and worsening while lying flat due to the inflamed pericardium contacting adjacent structures. Patients may also present with symptoms not specific to pericardial effusion, including dyspnea, edema, and fatigue. […] The clinical presentation of pericardial effusion ranges from being a clinically irrelevant, incidental finding to becoming a life-threatening cardiac tamponade. This wide variation is mainly due to the variable accumulation rate of the pericardial fluid. Acute accumulation may cause impaired cardiac filling and decreased cardiac output with as little as 100 mL of fluid. In contrast, chronic and slow accumulation may lead to significant effusions of 1 to 2 liters that produce no significant hemodynamic effects.

• #1 Pericardial Effusion: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17351-pericardial-effusion

  When an effusion happens quickly, it needs less fluid to become dangerous and cause cardiac tamponade. Thats because your pericardium doesnt have time to stretch and expand to fit more fluid inside it. When a pericardial effusion happens slowly, it can take weeks or even months before it becomes a problem. […] Large effusions and effusions that grow quickly are serious conditions that need quick medical care. They shouldnt last any longer than it takes to diagnose and treat them, especially in emergency cases.

• #1 Pericardial Effusion: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/157325-overview

  Signs and symptoms of pericardial effusion include the following: Chest pain, pressure, discomfort […] Light-headedness, syncope […] Palpitations […] Cough […] Dyspnea […] Hoarseness […] Anxiety and confusion […] Hiccoughs. […] Pericardial effusions can be acute or chronic, and the time course of development has a great impact on the patient’s symptoms. […] Clinical manifestations of pericardial effusion are highly dependent on the rate of accumulation of fluid in the pericardial sac. Rapid accumulation of pericardial fluid may cause elevated intrapericardial pressures with as little as 80 mL of fluid, while slowly progressing effusions can grow to 2 L without symptoms. […] As intrapericardial pressures rise, as occurs in the development of a pericardial effusion, this effect becomes pronounced, which can lead to a clinically significant fall in stroke volume and eventually progress to the development of pericardial tamponade.

• #1 Pericarditis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/myocarditis-and-pericarditis/pericarditis

  Cardiac tamponade occurs when a moderate or large pericardial effusion impairs cardiac filling, leading to low cardiac output and sometimes shock and death. […] If fluid (usually blood) accumulates rapidly, even small amounts (eg, 150 mL) may cause tamponade because the pericardium cannot stretch quickly enough to accommodate it. Conversely, slow accumulation of up to 1500 mL may not cause tamponade. […] In post-MI syndrome, pericardial effusion can occur with fever, friction rub, pleurisy, pleural effusions, and joint pain. This syndrome usually occurs within 10 days to 2 months after MI. It is usually mild but may be severe. […] Symptoms and signs of peripheral venous congestion (eg, peripheral edema, neck vein distention, hepatomegaly) may appear with an early diastolic sound (pericardial knock), often best heard during inspiration. This sound is due to abrupt slowing of diastolic ventricular filling by the rigid pericardium.

• #1 Pericardial Effusion | Symptoms and Treatment | MedStar Health

  https://www.medstarhealth.org/services/pericardial-effusion

  Pericardial effusion can come on quickly (acute) or develop slowly over time (chronic). A small pericardial effusion may not cause symptoms, but will appear in imaging tests. […] Symptoms of pericardial effusion may include: Chest pain or pressure, Shortness of breath, Nausea, Difficulty swallowing. […] If your disease has progressed to cardiac tamponade, your lips and skin may appear blue, you may go into shock, or you may lose some mental function. Tamponade is life threatening and requires immediate medical attention.

• #1

  https://www.nni.com.sg/patient-care/conditions-treatments/pericardial-effusion

  Some signs of pericardial effusion include: Chest pain or chest fullness, Difficulty breathing, Discomfort when breathing especially when lying down. However, a patient may not develop any symptoms, especially when the fluid has accumulated slowly. […] The condition exerts pressure on the heart and can lead to heart failure or death if left untreated.

• #1 Pericardial Effusion: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/157325-overview

  Most patients with acute pericarditis recover without sequelae. Predictors of a worse outcome include the following: A large pericardial effusion (20 mm echo-free space or evidence of tamponade) […] Patients with symptomatic pericardial effusions from HIV/AIDS or cancer have high short-term mortality rates. […] The morbidity and mortality of pericardial effusion is dependent on etiology and comorbid conditions. Pericardial effusion is the primary or contributory cause of death in 86% of cancer patients with symptomatic effusions.

• #1 Pericardial Effusion: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/pericardial-effusion-6888936

  In severe cases, pericardial effusion can lead to cardiac tamponade. Cardiac tamponade occurs when the buildup of pericardial fluid is enough to seriously compromise heart function. […] A severe effusion or cardiac tamponade can lead to the heart being unable to fill with blood to pump it out to the body. This results in cardiogenic shock (extremely low blood pressure), which can lead to organ failure or death. […] The prognosis is poor for people with fungal or bacterial pericarditis or pericardial effusion due to advanced cancer.

• #1

  https://www.cgh.com.sg/patient-care/conditions-treatments/pericardial-effusion

  Some signs of pericardial effusion include: […] However, a patient may not develop any symptoms, especially when the fluid has accumulated slowly. […] The condition exerts pressure on the heart and can lead to heart failure or death if left untreated.

• #1 Pericardial effusion: causes and clinical outcomes in dogs (Proceedings)

  https://www.dvm360.com/view/pericardial-effusion-causes-and-clinical-outcomes-dogs-proceedings-0

  Cardiac tamponade is diagnosed when there is diastolic collapse of the right atrium and/or right ventricle, and indicates that the pericardial effusion is hemodynamically compromising and requires timely pericardiocentesis. […] Approximately 50% of idiopathic pericarditis cases have recurrent pericardial effusion. […] Half of dogs with pericardial effusion had evidence of right heart failure, with equal occurrence of ascites or pleural effusion (50% and 47% respectively), with fewer dogs having concurrent ascites and pleural effusion (33%). […] Cardiac tamponade was subjectively suspected on echocardiography in 39% of dogs. […] Based on echocardiographic classification, dogs with no cardiac mass lived longer (MST 10.1 months) than dogs with echocardiographic evidence of a cardiac mass (MST 0.5 months, P= 0.0001). Dogs with a heart base mass diagnosed by echocardiography lived longer (MST 5.2 months) compared to dogs with a right atrial mass diagnosed by echocardiography (MST 0.03 months, P= 0.0002). All deaths recorded were caused by the specific etiology of the pericardial effusion and not due to other systemic disease.

• #1 Diagnosis and management of pericardial effusion

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3110902/

  Pericardial effusion is a common finding in everyday clinical practice. […] The presence of acute inflammatory signs (chest pain, fever, pericardial friction rub) is predictive for acute idiopathic pericarditis irrespective of the size of the effusion or the presence or absence of tamponade. […] Severe effusion with absence of inflammatory signs and absence of tamponade is predictive for chronic idiopathic pericardial effusion, and tamponade without inflammatory signs for neoplastic pericardial effusion. […] Clinical tamponade is the most severe manifestation of hemodynamic compromise caused by a tense pericardial effusion. The picture is easily recognized through the presence of the typical findings of dyspnea, tachycardia, jugular venous distension, pulsus paradoxus, and in the more severe cases arterial hypotension and even shock.

• #1 Cardiac Tamponade: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21906-cardiac-tamponade

  When this condition happens quickly, cardiac tamponade symptoms may include: […] When the condition happens more slowly, you may also have these cardiac tamponade symptoms: […] Cardiac tamponade is dangerous because it ultimately limits the amount of blood your heart can pump (cardiac output). This deprives your body of blood and oxygen. Eventually, it can cause your heart to stop entirely, a potentially fatal condition called cardiac arrest. […] If you get quick treatment for cardiac tamponade, you’ll probably have a good outlook. Your prognosis gets worse with a delay in treatment.

• #1 Pericardial Effusion: Causes, Symptoms and Treatment | Doctor

  https://patient.info/doctor/pericardial-effusion

  Pericardial friction rub: the most important physical sign of acute pericarditis. High-pitched and most often heard during expiration with the patient upright and leaning forward. […] Tachycardia. […] The heart may move within the pericardial cavity (’swinging heart’) where there is a large pericardial effusion. This unusual motion of the heart creates 'pseudo’ conditions like pseudomitral valve prolapse, pseudosystolic anterior motion of the mitral valve, paradoxical motion of the interventricular septum and midsystolic aortic valve closure. […] Respiratory signs include tachypnoea, decreased breath sounds and Ewart’s sign (dullness to percussion beneath the angle of the left scapula due to compression of the left lung by pericardial fluid). […] Other signs include hepatosplenomegaly, weakened peripheral pulses, oedema and cyanosis.

• #1 Diagnosis and management of pericardial effusion

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3110902/

  Most patients with a large (more than 20 mm), chronic (longer than 3 mo), idiopathic pericardial effusion are asymptomatic and may remain clinically stable for many years. However, this condition may entail a less than good prognosis, as unexpected overt tamponade can develop in up to 29% of such patients. […] The trigger of tamponade is unknown, but hypovolemia, paroxysmal tachyarrhythmias, and intercurrent acute pericarditis may precipitate tamponade; accordingly, these events should be vigorously managed.

• #1 Learning Radiology – Pericardial, effusion, fluid, pericardium

  http://learningradiology.com/archives04/COW%20112-Pericardial%20effusion/percardeffuscorrect.htm

  Small effusions frequently produce no symptoms […] Chest pain or discomfort with a characteristic of being relieved by sitting up or leaning forward and worsened in the supine position […] Syncope […] Palpitations […] Shortness of breath, tachypnea […] Muffled or distant heart sounds, tachycardia […] Hypotension […] Jugular venous distension […] Pulsus paradoxus […] Rate of accumulation of fluid is proportional to severity of symptoms […] The faster the fluid accumulates, the more severe the symptoms […] Requires about 150-250cc before cardiac tamponade occurs […] About 7-10% of those with pericardial effusion are at risk for developing tamponade […] Tamponade compresses heart and causes low cardiac output […] Most effusions do not lead to cardiac tamponade […] Size of cardiac silhouette is frequently increased.

• #1 Pericardial Effusion: Symptoms, Causes and Treatment | Ada

  https://ada.com/conditions/pericardial-effusion/

  Often, pericardial effusion is mild, progresses slowly, does not cause any signs or symptoms, and is discovered incidentally as part of a routine medical check-up. However, if the pericardial effusion develops or progresses rapidly, the pressure it exerts may compromise the functioning of the heart and lead to serious complications, particularly where there is a large amount of fluid. […] Signs of pericardial effusion may include: Chest pain, Rapid heartbeat, Feeling lightheaded, Fainting. […] Signs and symptoms depend on the size of the heart effusion and the rate at which it develops. People with small pericardial effusions that have developed slowly may not experience any specific symptoms at all. However, there may be symptoms related to the underlying cause, for example, fever from pericarditis.

• #1 Pericardial Effusion | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/pericardial-effusion

  Pericardial effusion is the buildup of extra fluid in the space around the heart. If too much fluid builds up, it can put pressure on the heart. This can prevent it from pumping normally. […] You may not have any symptoms. This is more often the case with a mild effusion. You might be more likely to have symptoms from whatever is causing the pericardial effusion. For example, you might have fever if you have an infection of the pericardial sac. […] When effusion is more severe, you may have symptoms such as: Chest pain or discomfort, Enlargement of the veins of the neck, Fainting, Fast breathing, Increased heart rate, Nausea, Pain in the right upper abdomen, Shortness of breath, Swelling in the arms and legs. […] If the effusion is very severe, it can also lead to very low blood pressure. This can cause symptoms of shock.

• #1 Pericardial Effusion

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/pericardial-effusion

  Symptoms from a pericardial effusion are related to pericarditis, if present, or cardiac tamponade. […] A large pericardial effusion can muffle the heart sounds, making them soft or even inaudible. A pericardial friction rub from pericarditis may be present. Ewarts sign is dullness to percussion at the left lung base due to compressive atelectasis from a large pericardial effusion. Auenbruggers sign is an epigastric bulge due to a large pericardial effusion extending subxiphoid. Compression of this bulge may cause hemodynamic compromise and cardiac tamponade. […] Physical exam findings of cardiac tamponade include sinus tachycardia, elevated jugular venous pressure with inspiration, pulsus paradoxus and, rarely, Kussmauls sign. Pulsus paradoxus reflects a decrease in systolic BP with inspiration of more than 12 mm Hg. Pulsus paradoxus also occurs in severe asthma or COPD exacerbations.

• #1 Pericarditis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/myocarditis-and-pericarditis/pericarditis

  Some patients present with symptoms and signs of inflammation (acute pericarditis); others present with those of fluid accumulation (pericardial effusion) or constriction. […] Symptoms and signs vary depending on the severity of inflammation and the amount and rate of fluid accumulation. Even a large amount of pericardial fluid may be asymptomatic if it develops slowly (eg, over months). […] Pericardial effusion is often painless, but when it occurs with acute pericarditis, pain may be present. Considerable amounts of pericardial fluid may muffle heart sounds, increase the area of cardiac dullness, and change the size and shape of the cardiac silhouette. […] The clinical findings of cardiac tamponade are similar to those of cardiogenic shock: decreased cardiac output, low systemic arterial pressure, tachycardia, and dyspnea.

• #1 Pericardial Effusion Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/157325-clinical

  Pericardial friction rub. […] Tachycardia. […] Hepatojugular reflux – This can be observed by applying pressure to the periumbilical region; a rise in the jugular venous pressure (JVP) of greater than 3 cm H2 O for more than 30 seconds suggests elevated central venous pressure (however, transient elevation in JVP may be normal). […] Respiratory findings can include the following: […] Tachypnea […] Decreased breath sounds – Secondary to pleural effusions. […] Ewart sign – Dullness to percussion beneath the angle of left scapula from compression of the left lung by pericardial fluid. […] Hepatosplenomegaly represents a GI symptom of pericardial effusion. Findings in the patients extremities can include weakened peripheral pulses, edema, and cyanosis.

• #1 Pericardial Effusion – Zero To Finals

  https://zerotofinals.com/surgery/cardiothoracic/pericardialeffusion/

  Pericardial effusion is where excess fluid collects within the pericardial sac. The speed of onset of symptoms relates to how quickly the effusion develops. A rapidly collecting effusion with cardiac tamponade can quickly cause haemodynamic compromise and collapse. Slowly developing, chronic effusions, may initially be asymptomatic. As pressure rises, symptoms can develop, which may include: Chest pain, Shortness of breath, A feeling of fullness in the chest, Orthopnoea (shortness of breath on lying flat). The effusion may compress surrounding structures, causing additional symptoms: Phrenic nerve compression can cause hiccups […] Signs on examination include: Quiet heart sounds, Pulsus paradoxus (an abnormally large fall in blood pressure during inspiration, notably when palpating the pulse), Hypotension, Raised JVP, Fever (with pericarditis), Pericardial rub (with pericarditis).

• #1 Pericardial effusion – Wikipedia

  https://en.wikipedia.org/wiki/Pericardial_effusion

  A pericardial effusion occurs when the volume of fluid in the cavity exceeds the normal limit. […] Some of the presenting symptoms are shortness of breath, chest pressure/pain, and malaise. […] Pericardial effusion presentation varies from person to person depending on the size, acuity and underlying cause of the effusion. […] Others with larger effusions may present with chest pressure or pain, dyspnea, shortness of breath, and malaise (a general feeling of discomfort or illness). […] Yet others with cardiac tamponade, a life-threatening complication, may present with dyspnea, low blood pressure, weakness, restlessness, hyperventilation (rapid breathing), discomfort with lying flat, dizziness, syncope or even loss of consciousness. […] This causes a type of shock, called obstructive shock, which can lead to organ damage.

• #1 Pericardial Effusion: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/pericardial-effusion-6888936

  Most people with a small pericardial effusion will have no symptoms caused by the effusion itself. It may be found incidentally during imaging for other reasons. […] You might experience symptoms due to the underlying cause of the pericardial effusion. For example, if an infection causes pericardial effusion, you may have a fever and chills. […] Symptoms of a larger pericardial effusion that is impacting the ability of the heart to pump blood effectively include: Anxiety, Chest pain, especially when lying down, Dry cough, Difficulty breathing while lying down, Abdominal or leg swelling, Light-headedness or fainting, Heart palpitations (feeling an unusual heartbeat), Enlarged veins in the neck, Fast breathing. […] The time the effusion takes to develop can also influence symptoms, as follows: Acute: Develops rapidly in less than a week, Subacute: Develops over one week to three months, Chronic: Develops over more than three months.

• #1 Pericarditis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pericarditis/symptoms-causes/syc-20352510

  Acute pericarditis begins suddenly but doesn’t last longer than four weeks. Future episodes can occur. It may be hard to tell the difference between acute pericarditis and pain due to a heart attack. […] Recurrent pericarditis occurs about 4 to 6 weeks after a bout of acute pericarditis. No symptoms happen in between. […] Incessant pericarditis lasts about 4 to 6 weeks but less than three months. The symptoms continue over this whole time. […] Chronic constrictive pericarditis usually develops slowly and lasts longer than three months. […] When pericarditis is found and treated early, the risk of complications usually becomes lower. Complications of pericarditis can include: Fluid buildup around the heart, also called pericardial effusion. The fluid buildup can lead to further heart complications. […] Pressure on the heart due to fluid buildup, also called cardiac tamponade. This life-threatening condition prevents the heart from filling properly. Less blood leaves the heart, causing a large drop in blood pressure. Cardiac tamponade requires emergency treatment.

• #1 Pericardial Effusion | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/pericardial-effusion

  Symptoms often improve greatly after the excess fluid is drained. The outcome of treatment may depend on the cause and severity of the condition, how quickly treatment is started, and your overall health. […] A large pericardial effusion can prevent the heart from pumping normally. This is a medical emergency. […] Seek medical attention right away if you have symptoms like severe chest pain or trouble breathing.

• #1 FF #209 Malignant Pericardial Effusions | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/malignant-pericardial-effusions/

  Malignant pericardial effusions (MPEs) are a rare complication of advanced cancer, but are associated with high morbidity and mortality. This Fast Fact discusses the diagnosis and management of MPEs. […] Signs and symptoms include peripheral and pulmonary edema, chest discomfort, cough, shortness of breath, and orthopnea. Severity of symptoms depends on the volume of the MPE as well as the rapidity of its accumulation; severe cases can present with cardiac tamponade and shock. […] Studies suggest a median survival of 2-3 months after a MPE is diagnosed, with a mean survival of 5 months for solid tumors and 20 months for hematologic malignancies.

• #1 Follow-Up and Treatment of Idiopathic Pericardial Effusion | AAFP

  https://www.aafp.org/pubs/afp/issues/2000/0515/p3148a.html

  Because the use of echocardiography in the evaluation of cardiac disorders has become routine, a growing number of patients have been diagnosed with pericardial effusion. […] Thirteen of the patients were initially asymptomatic, seven presented with atypical chest pain and seven were admitted to the hospital with overt cardiac tamponade. […] During follow-up, five patients underwent early pericardiectomy because of the presence of symptoms or the recurrence of a large effusion. […] Patients who are asymptomatic after initial evaluation could be followed with serial echocardiography; however, overt tamponade may occur unexpectedly. Thus, pericardiocentesis should be performed in most patients. Anterior pericardiectomy should be considered in patients with recurrence of fluid or those who develop symptoms of tamponade.

• #1 Minoxidil Induced Pericardial Effusion – SHM Abstracts | Society of Hospital Medicine

  https://shmabstracts.mystagingwebsite.com/abstract/minoxidil-induced-pericardial-effusion/

  Most cases of pericardial effusion resolve spontaneously upon cessation of Minoxidil. Discontinuation of Minoxidil resulted in the resolution of symptoms and pericardial effusion which prevented more aggressive means of pericardial drainage like pericardial window. […] The incidence of pericardial effusion is low, being reported in up to 3% of patients taking Minoxidil. However Minoxidil induced pericardial effusion should be considered in patients treated with this drug as medication discontinuation is associated with cessation of symptoms and resolution of pericardial fluid.

• #1 Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?

  https://www.mdpi.com/2077-0383/13/13/3887

  Pericardial effusions, especially large ones, have traditionally been regarded with concern by clinicians due to the sometimes unpredictable development of life-threatening cardiac tamponade. […] The clinical presentation covers a wide spectrum of manifestations ranging from a completely asymptomatic patient to a patient with severe symptoms such as dyspnea, fatigue, palpitations, or even circulatory collapse due to cardiac tamponade. […] The rate of accumulation of pericardial fluid is the main parameter correlating with symptoms’ development, since slowly accumulating effusion may be asymptomatic even if large. […] In contrast, small but fast-accumulating effusions, which may be observed after cardiac trauma, may cause significant hemodynamic impairment. […] Clinical examination in large pericardial effusions may reveal muffled heart sounds, jugular vein distension, and occasionally peripheral stasis.

• #1 Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?

  https://www.mdpi.com/2077-0383/13/13/3887

  Pulsus paradoxus during blood pressure measurement is the hallmark for the diagnosis of cardiac tamponade. […] The subset of patients who present with pericardial effusion in the setting of acute pericarditis will complain of pleuritic (pericarditic)-type chest pain. […] In the presence of small or moderate effusions, regular follow-up every 3–6 months is sufficient. In contrast, in cases of chronic (lasting more than 3 months) large pericardial effusions, pericardial drainage should be considered according to the Guidelines. […] Recent investigations published after the 2015 Guidelines have challenged the practice of performing pericardial drainage in asymptomatic subjects, with large, chronic, idiopathic, C-reactive-protein-negative pericardial effusions. […] The results of the aforementioned investigations suggest the need for caution regarding the use of pericardial drainage in chronic and large oligo- or asymptomatic patients and C-reactive-protein-negative pericardial effusions. […] In view of the new evidence, this condition has an overall benign course, and a non-invasive watchful waiting approach is the most appropriate choice in clinical practice.

• #1 Pericarditis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pericarditis/symptoms-causes/syc-20352510

  Chest pain is the most common symptom of pericarditis. It usually feels sharp or stabbing. But some people have dull, achy or pressure-like chest pain. […] Most often, pericarditis pain is felt behind the breastbone or on the left side of the chest. The pain may: Spread to the left shoulder and neck, or to both shoulders. Get worse when coughing, lying down or taking a deep breath. Get better when sitting up or leaning forward. […] Other symptoms of pericarditis can include: Cough. Fatigue or general feeling of weakness or being sick. Swelling of the legs or feet. Low-grade fever. Pounding or racing heartbeat, also called heart palpitations. Shortness of breath when lying down. Swelling of the belly, also called the abdomen. […] The specific symptoms depend on the type of pericarditis. Pericarditis is grouped into different categories, according to the pattern of symptoms and how long symptoms last.

• #1 Eletrical alternans: the ECG in pericardial effusion & cardiac tamponade – The Cardiovascular

  https://ecgwaves.com/topic/pericardial-effusion-cardiac-tamponade-electrical-alternans-ecg/

  The classical signs of cardiac tamponade are hypotension, muffled heart sounds and jugular venous distention. Other frequent symptoms are pulsus paradoxus, pericardial friction sounds, tachycardia, tachypnea, weakened peripheral pulses, edema, cyanosis. […] Significant pericardial effusion may bring about the following ECG changes: Electrical alternans: The amplitude of the QRS complexes vary from one beat to another (in the same lead). This is due to the swinging back and forth of the heart in the pericardial space.

• #2 UC San Diego Health Health Library | San Diego Hospital, Healthcare

  https://myhealth.ucsd.edu/Library/Encyclopedia/134,566

  You may not have any symptoms. This is more often the case with a mild effusion. You might be more likely to have symptoms from whatever is causing the pericardial effusion. For example, you might have fever if you have an infection of the pericardial sac. […] When effusion is more severe, you may have symptoms such as: Chest pain or discomfort, Enlargement of the veins of the neck, Fainting, Fast breathing, Increased heart rate, Nausea, Pain in the right upper abdomen, Shortness of breath, Swelling in the arms and legs. […] If the effusion is very severe, it can also lead to very low blood pressure. This can cause symptoms of shock. These include: Lightheadedness or dizziness, Cool arms and legs, Clammy skin, Weakness, Rapid breathing, Nausea or vomiting, Pale skin, Less urine output. […] Symptoms often improve greatly after the excess fluid is drained. The outcome of treatment may depend on the cause and severity of the condition, how quickly treatment is started, and your overall health.

• #2 Pericardial Effusion | Clinical Heart and Vascular Center | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/pericardial-effusion/

  The volume of fluid and rate of accumulation determine the presence of symptoms with pericardial effusion. The condition doesnt always cause symptoms, but when they are present, they can include: […] Chest pain, pressure, or discomfort, relieved by sitting up or leaning forward and worsened by lying flat. […] A large pericardial effusion puts pressure on the heart and prevents it from functioning properly. Extreme fluid accumulation can cause a life-threatening condition called cardiac tamponade.

• #2 Pericardial Effusion – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431089/

  Pericardial effusion is diagnosed using a combination of clinical evaluation and imaging techniques, with echocardiography being the primary method for confirming the presence of fluid around the heart. Symptoms may include chest pain and dyspnea, with electrocardiography and additional imaging providing supportive information. […] In patients with pericardial effusion due to pericarditis, patients often present with chest pain and dyspnea, with symptoms improving while sitting upright and worsening while lying flat due to the inflamed pericardium contacting adjacent structures. Patients may also present with symptoms not specific to pericardial effusion, including dyspnea, edema, and fatigue. […] The clinical presentation of pericardial effusion ranges from being a clinically irrelevant, incidental finding to becoming a life-threatening cardiac tamponade. This wide variation is mainly due to the variable accumulation rate of the pericardial fluid. Acute accumulation may cause impaired cardiac filling and decreased cardiac output with as little as 100 mL of fluid. In contrast, chronic and slow accumulation may lead to significant effusions of 1 to 2 liters that produce no significant hemodynamic effects.

• #2 Pericardial Effusion | Symptoms and Treatment | MedStar Health

  https://www.medstarhealth.org/services/pericardial-effusion

  Pericardial effusion can come on quickly (acute) or develop slowly over time (chronic). A small pericardial effusion may not cause symptoms, but will appear in imaging tests. […] Symptoms of pericardial effusion may include: Chest pain or pressure, Shortness of breath, Nausea, Difficulty swallowing. […] If your disease has progressed to cardiac tamponade, your lips and skin may appear blue, you may go into shock, or you may lose some mental function. Tamponade is life threatening and requires immediate medical attention.

• #2 Pericardial Effusion: Symptoms, Causes and Treatment | Ada

  https://ada.com/conditions/pericardial-effusion/

  Where present, symptoms of pericardial effusion may include: Feeling light-headed or fainting, Palpitations, Rapid heartbeat (tachycardia), Shortness of breath or difficulty breathing, Chest pain, pressure or discomfort. This symptom may be worse when lying flat on the back, and relieved by sitting up and leaning forward, Cough, Difficulty swallowing, Hoarseness, Anxiety and confusion, Hiccups, Nausea and vomiting, Feeling of fullness in the abdomen, Abdominal distension (bloating). […] A possible complication of pericardial effusion is cardiac tamponade, which is a medical emergency requiring immediate intervention. […] Symptoms of cardiac tamponade may develop rapidly (within minutes or hours) and can include: Shortness of breath, Weakness and faintness, Nausea, Palpitations, Confusion or loss of consciousness, Blurred vision.

• #2 Pericarditis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pericarditis/symptoms-causes/syc-20352510

  Chest pain is the most common symptom of pericarditis. It usually feels sharp or stabbing. But some people have dull, achy or pressure-like chest pain. […] Most often, pericarditis pain is felt behind the breastbone or on the left side of the chest. The pain may: Spread to the left shoulder and neck, or to both shoulders. Get worse when coughing, lying down or taking a deep breath. Get better when sitting up or leaning forward. […] Other symptoms of pericarditis can include: Cough. Fatigue or general feeling of weakness or being sick. Swelling of the legs or feet. Low-grade fever. Pounding or racing heartbeat, also called heart palpitations. Shortness of breath when lying down. Swelling of the belly, also called the abdomen. […] The specific symptoms depend on the type of pericarditis. Pericarditis is grouped into different categories, according to the pattern of symptoms and how long symptoms last.

• #2 Pericardial Effusion | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/pericardial-effusion

  Pericardial effusion is the buildup of extra fluid in the space around the heart. If too much fluid builds up, it can put pressure on the heart. This can prevent it from pumping normally. […] You may not have any symptoms. This is more often the case with a mild effusion. You might be more likely to have symptoms from whatever is causing the pericardial effusion. For example, you might have fever if you have an infection of the pericardial sac. […] When effusion is more severe, you may have symptoms such as: Chest pain or discomfort, Enlargement of the veins of the neck, Fainting, Fast breathing, Increased heart rate, Nausea, Pain in the right upper abdomen, Shortness of breath, Swelling in the arms and legs. […] If the effusion is very severe, it can also lead to very low blood pressure. This can cause symptoms of shock.

• #2 Pericardial Effusion: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/157325-overview

  Signs and symptoms of pericardial effusion include the following: Chest pain, pressure, discomfort […] Light-headedness, syncope […] Palpitations […] Cough […] Dyspnea […] Hoarseness […] Anxiety and confusion […] Hiccoughs. […] Pericardial effusions can be acute or chronic, and the time course of development has a great impact on the patient’s symptoms. […] Clinical manifestations of pericardial effusion are highly dependent on the rate of accumulation of fluid in the pericardial sac. Rapid accumulation of pericardial fluid may cause elevated intrapericardial pressures with as little as 80 mL of fluid, while slowly progressing effusions can grow to 2 L without symptoms. […] As intrapericardial pressures rise, as occurs in the development of a pericardial effusion, this effect becomes pronounced, which can lead to a clinically significant fall in stroke volume and eventually progress to the development of pericardial tamponade.

• #2 Pericardial Effusion: Causes, Symptoms and Treatment | Doctor

  https://patient.info/doctor/pericardial-effusion

  The symptoms produced by a pericardial effusion depend on the speed with which the effusion is formed, as well as the size of the effusion. Many small-to-moderate effusions formed over a long period of time will be relatively asymptomatic. However, even small effusions which have occurred rapidly may compromise the circulation and cause tamponade. […] Chest pain, pressure, discomfort: pericardial pain may be relieved by sitting up and leaning forward and is intensified by lying supine. […] Light-headedness, syncope. […] Palpitations. […] Cough, shortness of breath, hoarseness. […] Anxiety and confusion. […] Hiccoughs. […] Classic triad of pericardial tamponade: hypotension, muffled heart sounds, jugular venous distention. […] Pulsus paradoxus: exaggeration of the normal respiratory variation in systemic blood pressure (defined as a decrease in systolic blood pressure of more than 10 mm Hg with inspiration). A pulsus paradoxus in patients with a pericardial effusion helps distinguish those with cardiac tamponade from those without.

• #2 Pericardial effusion – Wikipedia

  https://en.wikipedia.org/wiki/Pericardial_effusion

  A pericardial effusion occurs when the volume of fluid in the cavity exceeds the normal limit. […] Some of the presenting symptoms are shortness of breath, chest pressure/pain, and malaise. […] Pericardial effusion presentation varies from person to person depending on the size, acuity and underlying cause of the effusion. […] Others with larger effusions may present with chest pressure or pain, dyspnea, shortness of breath, and malaise (a general feeling of discomfort or illness). […] Yet others with cardiac tamponade, a life-threatening complication, may present with dyspnea, low blood pressure, weakness, restlessness, hyperventilation (rapid breathing), discomfort with lying flat, dizziness, syncope or even loss of consciousness. […] This causes a type of shock, called obstructive shock, which can lead to organ damage.

• #2 Pericardial Effusion | Ohio State Medical Center

  https://wexnermedical.osu.edu/heart-vascular/cardiology/pericardial-effusion

  A buildup of extra fluid around the heart can create pressure strong enough to interfere with your heart beating normally. […] You may feel chest pain, have shortness of breath or low blood pressure. […] Without treatment, the condition can become severe leading to heart failure or death. […] Small pericardial effusions may not cause any symptoms at all. You’re more likely to experience symptoms when an effusion is more severe or comes on quickly. […] Symptoms can mimic those of heart failure, including difficulty catching your breath, chest pain and coughing. […] Other symptoms include painful breathing, fever, rapid heart rate and fainting. […] If your effusion is very large, you may also experience trouble swallowing, hiccups or hoarseness.

• #2 Pericardial Effusion Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/157325-clinical

  Cardiovascular symptoms in pericardial effusion can include the following: […] Chest pain, pressure, discomfort – Characteristically, pericardial pain may be relieved by sitting up and leaning forward and is intensified by lying supine. […] Light-headedness, syncope […] Palpitations. […] Respiratory symptoms can include the following: […] Cough […] Dyspnea […] Hoarseness. […] Neurologic symptoms of pericardial effusion can include anxiety and confusion, while hiccoughs may occur as a gastrointestinal (GI) symptom. […] Classic Beck triad of pericardial tamponade – Hypotension, muffled heart sounds, jugular venous distention. […] Pulsus paradoxus – Exaggeration of physiologic respiratory variation in systemic blood pressure, defined as a decrease in systolic blood pressure of more than 10mm Hg with inspiration, signaling falling cardiac output during inspiration.

• #2 Pericardial Effusion

  https://fpnotebook.com/CV/Pericardium/PrcrdlEfsn.htm

  Symptomatic threshold for Pericardial Effusion: Acute (rapidly progressive): 200 ml […] Chronic: May not be significantly symptomatic until 1-2 Liters are present. […] Common Symptoms: Chest Pain […] Shortness of Breath (especially exertional Dyspnea) […] Palpitations.

• #2 Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?

  https://www.mdpi.com/2077-0383/13/13/3887

  Pericardial effusions, especially large ones, have traditionally been regarded with concern by clinicians due to the sometimes unpredictable development of life-threatening cardiac tamponade. […] The clinical presentation covers a wide spectrum of manifestations ranging from a completely asymptomatic patient to a patient with severe symptoms such as dyspnea, fatigue, palpitations, or even circulatory collapse due to cardiac tamponade. […] The rate of accumulation of pericardial fluid is the main parameter correlating with symptoms’ development, since slowly accumulating effusion may be asymptomatic even if large. […] In contrast, small but fast-accumulating effusions, which may be observed after cardiac trauma, may cause significant hemodynamic impairment. […] Clinical examination in large pericardial effusions may reveal muffled heart sounds, jugular vein distension, and occasionally peripheral stasis.

• #2 FF #209 Malignant Pericardial Effusions | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/malignant-pericardial-effusions/

  Malignant pericardial effusions (MPEs) are a rare complication of advanced cancer, but are associated with high morbidity and mortality. This Fast Fact discusses the diagnosis and management of MPEs. […] Signs and symptoms include peripheral and pulmonary edema, chest discomfort, cough, shortness of breath, and orthopnea. Severity of symptoms depends on the volume of the MPE as well as the rapidity of its accumulation; severe cases can present with cardiac tamponade and shock. […] Studies suggest a median survival of 2-3 months after a MPE is diagnosed, with a mean survival of 5 months for solid tumors and 20 months for hematologic malignancies.

• #2 Pericardial Effusion: Risks of Delayed and Misdiagnosis when Fluid Collects around the Heart

  https://www.fronzutolaw.com/articles/pericardial-effusion-risks-of-delayed-and-misdiagnosis-when-fluid-collects-around-the-heart/

  Unfortunately, the longer a condition like cardiac tamponade, a complication of pericardial effusion, remains untreated, the more dangerous it becomes. More fluid builds up, causing a patients blood pressure to drop quickly, especially if the accumulation is rapid. If it is not diagnosed and treated fast enough, the patient can suffer permanent organ damage or die from the impeded blood flow or shock. […] A doctor who misdiagnoses pericardial effusion causes a delay in important treatment with potentially dire results. In fact, a delayed diagnosis or delay in treating fluid accumulation around the heart is among the most deadly mistakes you can make as an emergency room physician, cardiologist, or other doctor who frequently sees patients with heart related symptoms like heart attacks or atrial fibrillation. […] Remember, fluid collecting around the heart when left undiagnosed or untreated can prove fatal.

• #2 Pericarditis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pericarditis/symptoms-causes/syc-20352510

  Acute pericarditis begins suddenly but doesn’t last longer than four weeks. Future episodes can occur. It may be hard to tell the difference between acute pericarditis and pain due to a heart attack. […] Recurrent pericarditis occurs about 4 to 6 weeks after a bout of acute pericarditis. No symptoms happen in between. […] Incessant pericarditis lasts about 4 to 6 weeks but less than three months. The symptoms continue over this whole time. […] Chronic constrictive pericarditis usually develops slowly and lasts longer than three months. […] When pericarditis is found and treated early, the risk of complications usually becomes lower. Complications of pericarditis can include: Fluid buildup around the heart, also called pericardial effusion. The fluid buildup can lead to further heart complications. […] Pressure on the heart due to fluid buildup, also called cardiac tamponade. This life-threatening condition prevents the heart from filling properly. Less blood leaves the heart, causing a large drop in blood pressure. Cardiac tamponade requires emergency treatment.

• #2 Understanding Pericardial Effusion | UNC Health Talkhealth wellnessstethoscopeStorieshealth wellnessstethoscopeStoriestwitter-iconfacebook-iconpinterest-iconemail-iconhealth wellnessstethoscopeStoriesfacebooktwitteryoutubepinterestinstagramLinkedIn

  https://healthtalk.unchealthcare.org/understanding-pericardial-effusion/

  Pericardial effusion is an alarming thing to experience: A common symptom of this condition is a sharp, stabbing chest pain that comes on quickly. Other common symptoms include shortness of breath and low blood pressure. […] The chest pain and shortness of breath common with pericardial effusion can seem like a heart attack or a sign of heart failure. So getting an electrocardiogram, or EKG, to detect and record your heart’s electrical activity is an essential first step for diagnosis. […] Untreated pericardial effusion puts pressure on the heart and impairs its function in the long run, potentially leading to heart failure or death.

• #2

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abr9813

  Symptoms depend on how much fluid there is and how fast the fluid builds up. […] Symptoms may include: Chest pain. […] Trouble breathing. […] Some people have no symptoms. […] If a lot of fluid builds up, it can cause increased pressure on your heart. This pressure is called cardiac tamponade. It is an emergency that can reduce the heart’s ability to pump blood. […] In some people, pericardial effusion comes back and must be treated again.

• #2 Pericardial Effusion

  https://www.healio.com/cardiology/learn-the-heart/cardiology-review/topic-reviews/pericardial-effusion

  Symptoms from a pericardial effusion are related to pericarditis, if present, or cardiac tamponade. […] A large pericardial effusion can muffle the heart sounds, making them soft or even inaudible. A pericardial friction rub from pericarditis may be present. Ewarts sign is dullness to percussion at the left lung base due to compressive atelectasis from a large pericardial effusion. Auenbruggers sign is an epigastric bulge due to a large pericardial effusion extending subxiphoid. Compression of this bulge may cause hemodynamic compromise and cardiac tamponade. […] Physical exam findings of cardiac tamponade include sinus tachycardia, elevated jugular venous pressure with inspiration, pulsus paradoxus and, rarely, Kussmauls sign. Pulsus paradoxus reflects a decrease in systolic BP with inspiration of more than 12 mm Hg. Pulsus paradoxus also occurs in severe asthma or COPD exacerbations.

• #2

  https://www.aurorahealthcare.org/services/heart-vascular/conditions/pericardial-effusion

  Fluid on the heart can build up slowly without any signs, so you may not even know you have the condition. But if you do have symptoms, its important to see your doctor as pericardial effusion can become serious and life-threatening. […] Symptoms of fluid around the heart can include: Dizziness or fainting (syncope), Nausea or abdominal fullness, Painful breathing, Rapid heartbeat, Shortness of breath. […] Certain fluid around the heart symptoms can signal pericardial effusion is severely affecting your heart. This a medical emergency. Call 911 if you or someone you know is experiencing: Blue-tinged skin or lips, Change in mental status, Shock, with symptoms such as dizziness, weakness, clammy or pale skin, cool arms and legs, rapid breathing, nausea or vomiting.

• #2 Pericardial Effusion: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/17351-pericardial-effusion

  Pericardial effusion is a buildup of fluid in the space around your heart. It can happen for many reasons, like infections, injuries or other medical conditions. If the buildup is severe or happens quickly, it can compress your heart and cause a life-threatening medical emergency. […] You may not have any pericardial effusion symptoms with a mild case. Symptoms are more likely when an effusion happens quickly, involves a large amount of fluid or causes cardiac tamponade. The main symptoms of pericardial effusions and cardiac tamponade include: Shortness of breath (dyspnea). Chest pressure or pain. Fast heartbeat or heart palpitations. Lightheadedness or dizziness. Fainting (syncope). Fatigue. Anxiety, confusion or other behavior changes (because of low blood flow to your brain). Cyanosis (a blue or gray tinge to your lips or under your fingernails that happens when you have low blood oxygen levels).

• #2 Diagnosis and management of pericardial effusion

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3110902/

  Pericardial effusion is a common finding in everyday clinical practice. […] The presence of acute inflammatory signs (chest pain, fever, pericardial friction rub) is predictive for acute idiopathic pericarditis irrespective of the size of the effusion or the presence or absence of tamponade. […] Severe effusion with absence of inflammatory signs and absence of tamponade is predictive for chronic idiopathic pericardial effusion, and tamponade without inflammatory signs for neoplastic pericardial effusion. […] Clinical tamponade is the most severe manifestation of hemodynamic compromise caused by a tense pericardial effusion. The picture is easily recognized through the presence of the typical findings of dyspnea, tachycardia, jugular venous distension, pulsus paradoxus, and in the more severe cases arterial hypotension and even shock.

• #2 Pericardial Effusion: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/157325-overview

  Most patients with acute pericarditis recover without sequelae. Predictors of a worse outcome include the following: A large pericardial effusion (20 mm echo-free space or evidence of tamponade) […] Patients with symptomatic pericardial effusions from HIV/AIDS or cancer have high short-term mortality rates. […] The morbidity and mortality of pericardial effusion is dependent on etiology and comorbid conditions. Pericardial effusion is the primary or contributory cause of death in 86% of cancer patients with symptomatic effusions.

• #2 Assessment of pericardial effusion – Differential diagnosis of symptoms | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/458

  Pericardial effusion is present when the fluid in the pericardial space exceeds its physiological amount (50 mL). In the clinical setting, pericardial effusion is relatively common. It may be detected incidentally on a cardiac or chest imaging study, or manifest on the background of a cardiac or systemic disease. […] The significance of effusions lies in their relationship to an underlying disease state and in their potential to affect a patient’s haemodynamics. […] The development of a pericardial effusion often has important implications for the diagnosis and/or prognosis of the underlying disease.

• #2 Pericardial Effusion: Causes, Symptoms and Treatment | Doctor

  https://patient.info/doctor/pericardial-effusion

  Pericardial friction rub: the most important physical sign of acute pericarditis. High-pitched and most often heard during expiration with the patient upright and leaning forward. […] Tachycardia. […] The heart may move within the pericardial cavity (’swinging heart’) where there is a large pericardial effusion. This unusual motion of the heart creates 'pseudo’ conditions like pseudomitral valve prolapse, pseudosystolic anterior motion of the mitral valve, paradoxical motion of the interventricular septum and midsystolic aortic valve closure. […] Respiratory signs include tachypnoea, decreased breath sounds and Ewart’s sign (dullness to percussion beneath the angle of the left scapula due to compression of the left lung by pericardial fluid). […] Other signs include hepatosplenomegaly, weakened peripheral pulses, oedema and cyanosis.

• #2 Learning Radiology – Pericardial, effusion, fluid, pericardium

  http://learningradiology.com/archives04/COW%20112-Pericardial%20effusion/percardeffuscorrect.htm

  Small effusions frequently produce no symptoms […] Chest pain or discomfort with a characteristic of being relieved by sitting up or leaning forward and worsened in the supine position […] Syncope […] Palpitations […] Shortness of breath, tachypnea […] Muffled or distant heart sounds, tachycardia […] Hypotension […] Jugular venous distension […] Pulsus paradoxus […] Rate of accumulation of fluid is proportional to severity of symptoms […] The faster the fluid accumulates, the more severe the symptoms […] Requires about 150-250cc before cardiac tamponade occurs […] About 7-10% of those with pericardial effusion are at risk for developing tamponade […] Tamponade compresses heart and causes low cardiac output […] Most effusions do not lead to cardiac tamponade […] Size of cardiac silhouette is frequently increased.

• #2 Pericarditis – Cardiovascular Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/cardiovascular-disorders/myocarditis-and-pericarditis/pericarditis

  Cardiac tamponade occurs when a moderate or large pericardial effusion impairs cardiac filling, leading to low cardiac output and sometimes shock and death. […] If fluid (usually blood) accumulates rapidly, even small amounts (eg, 150 mL) may cause tamponade because the pericardium cannot stretch quickly enough to accommodate it. Conversely, slow accumulation of up to 1500 mL may not cause tamponade. […] In post-MI syndrome, pericardial effusion can occur with fever, friction rub, pleurisy, pleural effusions, and joint pain. This syndrome usually occurs within 10 days to 2 months after MI. It is usually mild but may be severe. […] Symptoms and signs of peripheral venous congestion (eg, peripheral edema, neck vein distention, hepatomegaly) may appear with an early diastolic sound (pericardial knock), often best heard during inspiration. This sound is due to abrupt slowing of diastolic ventricular filling by the rigid pericardium.

• #2

  https://www.cgh.com.sg/patient-care/conditions-treatments/pericardial-effusion

  Some signs of pericardial effusion include: […] However, a patient may not develop any symptoms, especially when the fluid has accumulated slowly. […] The condition exerts pressure on the heart and can lead to heart failure or death if left untreated.

• #2 Pericardial Effusion: Symptoms, Causes, Diagnosis, Treatment

  https://www.verywellhealth.com/pericardial-effusion-6888936

  In severe cases, pericardial effusion can lead to cardiac tamponade. Cardiac tamponade occurs when the buildup of pericardial fluid is enough to seriously compromise heart function. […] A severe effusion or cardiac tamponade can lead to the heart being unable to fill with blood to pump it out to the body. This results in cardiogenic shock (extremely low blood pressure), which can lead to organ failure or death. […] The prognosis is poor for people with fungal or bacterial pericarditis or pericardial effusion due to advanced cancer.

• #2 Cardiac Tamponade: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21906-cardiac-tamponade

  When this condition happens quickly, cardiac tamponade symptoms may include: […] When the condition happens more slowly, you may also have these cardiac tamponade symptoms: […] Cardiac tamponade is dangerous because it ultimately limits the amount of blood your heart can pump (cardiac output). This deprives your body of blood and oxygen. Eventually, it can cause your heart to stop entirely, a potentially fatal condition called cardiac arrest. […] If you get quick treatment for cardiac tamponade, you’ll probably have a good outlook. Your prognosis gets worse with a delay in treatment.

• #2 Pericardial effusion: causes and clinical outcomes in dogs (Proceedings)

  https://www.dvm360.com/view/pericardial-effusion-causes-and-clinical-outcomes-dogs-proceedings-0

  Cardiac tamponade is diagnosed when there is diastolic collapse of the right atrium and/or right ventricle, and indicates that the pericardial effusion is hemodynamically compromising and requires timely pericardiocentesis. […] Approximately 50% of idiopathic pericarditis cases have recurrent pericardial effusion. […] Half of dogs with pericardial effusion had evidence of right heart failure, with equal occurrence of ascites or pleural effusion (50% and 47% respectively), with fewer dogs having concurrent ascites and pleural effusion (33%). […] Cardiac tamponade was subjectively suspected on echocardiography in 39% of dogs. […] Based on echocardiographic classification, dogs with no cardiac mass lived longer (MST 10.1 months) than dogs with echocardiographic evidence of a cardiac mass (MST 0.5 months, P= 0.0001). Dogs with a heart base mass diagnosed by echocardiography lived longer (MST 5.2 months) compared to dogs with a right atrial mass diagnosed by echocardiography (MST 0.03 months, P= 0.0002). All deaths recorded were caused by the specific etiology of the pericardial effusion and not due to other systemic disease.

• #2 Pericardial Effusion

  https://healthlibrary.brighamandwomens.org/library/Encyclopedia/134,566

  Pericardial effusion is the buildup of extra fluid in the space around the heart. If too much fluid builds up, it can put pressure on the heart. This can prevent it from pumping normally. […] You may not have any symptoms. This is more often the case with a mild effusion. You might be more likely to have symptoms from whatever is causing the pericardial effusion. For example, you might have fever if you have an infection of the pericardial sac. […] When effusion is more severe, you may have symptoms such as: Chest pain or discomfort, Enlargement of the veins of the neck, Fainting, Fast breathing, Increased heart rate, Nausea, Pain in the right upper abdomen, Shortness of breath, Swelling in the arms and legs. […] If the effusion is very severe, it can also lead to very low blood pressure. This can cause symptoms of shock. These include: Lightheadedness or dizziness, Cool arms and legs, Clammy skin, Weakness, Rapid breathing, Nausea or vomiting, Pale skin, Less urine output. […] Symptoms often improve greatly after the excess fluid is drained. The outcome of treatment may depend on the cause and severity of the condition, how quickly treatment is started, and your overall health.

• #2 Asymptomatic Chronic Large Pericardial Effusions: To Drain or to Observe?

  https://www.mdpi.com/2077-0383/13/13/3887

  Pulsus paradoxus during blood pressure measurement is the hallmark for the diagnosis of cardiac tamponade. […] The subset of patients who present with pericardial effusion in the setting of acute pericarditis will complain of pleuritic (pericarditic)-type chest pain. […] In the presence of small or moderate effusions, regular follow-up every 3–6 months is sufficient. In contrast, in cases of chronic (lasting more than 3 months) large pericardial effusions, pericardial drainage should be considered according to the Guidelines. […] Recent investigations published after the 2015 Guidelines have challenged the practice of performing pericardial drainage in asymptomatic subjects, with large, chronic, idiopathic, C-reactive-protein-negative pericardial effusions. […] The results of the aforementioned investigations suggest the need for caution regarding the use of pericardial drainage in chronic and large oligo- or asymptomatic patients and C-reactive-protein-negative pericardial effusions. […] In view of the new evidence, this condition has an overall benign course, and a non-invasive watchful waiting approach is the most appropriate choice in clinical practice.

• #2 Pericarditis | Pericardial Disorders | MedlinePlus

  https://medlineplus.gov/pericardialdisorders.html

  Symptoms of pericardial problems include chest pain, rapid heartbeat, and difficulty breathing. […] Fever is a common symptom of acute pericarditis.

• #3 Pericardial Effusion: Symptoms, Causes and Treatment | Ada

  https://ada.com/conditions/pericardial-effusion/

  Often, pericardial effusion is mild, progresses slowly, does not cause any signs or symptoms, and is discovered incidentally as part of a routine medical check-up. However, if the pericardial effusion develops or progresses rapidly, the pressure it exerts may compromise the functioning of the heart and lead to serious complications, particularly where there is a large amount of fluid. […] Signs of pericardial effusion may include: Chest pain, Rapid heartbeat, Feeling lightheaded, Fainting. […] Signs and symptoms depend on the size of the heart effusion and the rate at which it develops. People with small pericardial effusions that have developed slowly may not experience any specific symptoms at all. However, there may be symptoms related to the underlying cause, for example, fever from pericarditis.

• #3 Cardiac Tamponade: Symptoms & Causes

  https://my.clevelandclinic.org/health/diseases/21906-cardiac-tamponade

  When this condition happens quickly, cardiac tamponade symptoms may include: […] When the condition happens more slowly, you may also have these cardiac tamponade symptoms: […] Cardiac tamponade is dangerous because it ultimately limits the amount of blood your heart can pump (cardiac output). This deprives your body of blood and oxygen. Eventually, it can cause your heart to stop entirely, a potentially fatal condition called cardiac arrest. […] If you get quick treatment for cardiac tamponade, you’ll probably have a good outlook. Your prognosis gets worse with a delay in treatment.

• #3 Pericardial Effusion: Risks of Delayed and Misdiagnosis when Fluid Collects around the Heart

  https://www.fronzutolaw.com/articles/pericardial-effusion-risks-of-delayed-and-misdiagnosis-when-fluid-collects-around-the-heart/

  Unfortunately, the longer a condition like cardiac tamponade, a complication of pericardial effusion, remains untreated, the more dangerous it becomes. More fluid builds up, causing a patients blood pressure to drop quickly, especially if the accumulation is rapid. If it is not diagnosed and treated fast enough, the patient can suffer permanent organ damage or die from the impeded blood flow or shock. […] A doctor who misdiagnoses pericardial effusion causes a delay in important treatment with potentially dire results. In fact, a delayed diagnosis or delay in treating fluid accumulation around the heart is among the most deadly mistakes you can make as an emergency room physician, cardiologist, or other doctor who frequently sees patients with heart related symptoms like heart attacks or atrial fibrillation. […] Remember, fluid collecting around the heart when left undiagnosed or untreated can prove fatal.

Zobacz więcej