7 - Mattu - Pericardial Effusion

Question 1

What is the “triad” of pericardial effusion?

Answer 1

• Low voltage ECG
• Tachycardia
• Cardiomegaly in CXR

Question 2

Baseline of ECG?

Answer 2

TP segment

Question 3

What is the formula for determining low voltage in Leads I-III?

Answer 3

I + II + III = < 15 mm

Question 4

What is the formula of low voltage ECG in leads V1 + V2 + V3?

Answer 4

V1 + V2 + V3 = < 30 mm

Question 5

“Low voltage + tachycardia” is an indicator of _______.

Answer 5

Pericardial effusion

Question 6

Explain what might cause a “low voltage” ECG?

Answer 6

◦ “weak battery”
‣ Lg. pericardial/pleural effusion - “blocking the battery/leads”
‣ obesity - blocking the “battery and leads”
‣ COPD - barrel chest is “blocking battery and leads”
‣ hypothyoroidism
‣ infiltrative disease (sarcoidosis)

Question 7

What medications may blunt the tachycardia associated with pleural/pericardial effusion?

Answer 7

• Ca2+ blockers
  
  • Ca2+ is important in maintaining phase 2 of the cardiac action potential
• Beta-blockers