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A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane .
Purulent Pericarditis; Echocardiogram showing pericardial effusion with signs of cardiac tamponade: Specialty: Cardiology: Symptoms: substernal chest pain (exacerbated supine and with breathing deeply), dyspnea, fever, rigors/chills, and cardiorespiratory signs (i.e., tachycardia, friction rub, pulsus paradoxus, pericardial effusion, cardiac tamponade, pleural effusion)
Cardiac tamponade, also known as pericardial tamponade (/ ˌ t æ m. p ə ˈ n eɪ d / [4]), is a compression of the heart due to pericardial effusion (the build-up of pericardial fluid in the sac around the heart). [2] Onset may be rapid or gradual. [2]
The pericardial rub is said to be generated from the friction generated by the two inflamed layers of the pericardium; however, even a large pericardial effusion does not necessarily present a rub. The rub is best heard during the maximal movement of the heart within the pericardial sac, namely, during atrial systole , ventricular systole, and ...
The diagnosis of tamponade can be confirmed with trans-thoracic echocardiography (TTE), which should show a large pericardial effusion and diastolic collapse of the right ventricle and right atrium. Chest X-ray usually shows an enlarged cardiac silhouette ("water bottle" appearance) and clear lungs. Pulmonary congestion is typically not seen ...
On a chest X-ray, the normal heart silhouette should have a clear and defined outline. However, in cases of pericardial effusion, the accumulation of fluid within the pericardial sac causes the heart to appear enlarged and assumes a shape that is reminiscent of a water bottle, with relatively smooth cardiac contours. [2]
Fluid can be removed from the pericardial space for diagnosis or to relieve tamponade using a syringe in a procedure called pericardiocentesis. [11] For cases of recurrent pericardial effusion, an operation to create a hole between the pericardial and pleural spaces can be performed, known as a pericardial window or pericardiostomy.
The differential diagnoses of Kussmaul's sign includes constrictive pericarditis, restrictive cardiomyopathy, pericardial effusion, and severe right-sided heart failure. [ citation needed ] With cardiac tamponade , jugular veins are distended and typically show a prominent x descent and an absent y descent as opposed to patients with ...