Pericardial Effusion

Pericardial effusion is an abnormal accumulation of fluid around the heart. The critical question is whether that fluid is causing cardiac tamponade and impaired ventricular filling.

In this episode, Chris and Mars review:

• Major causes of pericardial effusion
• Why the rate of fluid accumulation matters
• Low-voltage E C G and electrical alternans
• Echocardiographic diagnosis
• Right atrial and right ventricular collapse
• Pericardial effusion versus cardiac tamponade
• When observation is appropriate
• When pericardiocentesis or surgical drainage is required

Episode pearl: The size of an effusion alone does not determine its danger. A rapidly accumulating small effusion can cause tamponade while a slowly developing large effusion may remain stable.

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