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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)
A transthoracic echocardiogram (TTE) is usually sufficient to evaluate pericardial effusion and it may also help distinguish pericardial effusion from pleural effusion and MI. Most pericardial effusions appear as an anechoic area (black or without an echo) between the visceral and the parietal membrane. [1]
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]
It is clinically similar to a pericardial effusion, and, depending on the volume and rapidity with which it develops, may cause cardiac tamponade. [ 1 ] The condition can be caused by full-thickness necrosis (death) of the myocardium (heart muscle) after myocardial infarction , chest trauma , [ 2 ] and by over-prescription of anticoagulants .
Beck's triad is a collection of three medical signs associated with acute cardiac tamponade, a medical emergency when excessive fluid accumulates in the pericardial sac around the heart and impairs its ability to pump blood. The signs are low arterial blood pressure, distended neck veins, and distant, muffled heart sounds. [1]
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 ...
Echocardiography can assess for pericardial effusion. In tamponade, collapse of the right atrium and ventricle would be seen due to pressure in the pericardial sac. [24] A chest X-ray can rapidly identify a pneumothorax, seen as absence of lung markings. Ultrasound can show the lack of lung sliding. However, imaging should not delay treatment. [8]
Pericardiocentesis is a procedure whereby the fluid in a pericardial effusion is removed through a needle. It is performed under the following conditions: [15] presence of moderate or severe cardiac tamponade; diagnostic purpose for suspected purulent, tuberculosis, or neoplastic pericarditis; persistent symptomatic pericardial effusion