Pericardial effusion

Question 1

What is a pericardial effusion?

Answer 1

Collection of fluid within the pericardial sac

Question 2

How can the causes of pericardial effusion be classified?

Answer 2

Transudative

Exudative

Question 3

Give a transudative cause of pericardial effusion

Answer 3

CCF

Question 4

What are the exudative causes of pericardial effusion?

Answer 4

Inflammatory causes (i.e. same as the causes of pericarditis):

• Viral infection e.g. EBV
• Autoimmune conditions e.g. SLE, RA
• Trauma or injury to the pericardium e.g. MI, surgery

Question 5

What ECG changes are associated with pericarditis?

Answer 5

Widespread:

• ST elevation
• PR depression

Question 6

Describe the ‘textbook’ chest pain in pericarditis

Answer 6

Retrosternal, pleuritic and positional (worse lying flat, relieved by sitting forward)

Question 7

Describe the investigation of pericardial effusion

Answer 7

Echo

Question 8

Describe the medical and interventional management of pericardial effusion

Answer 8

Medical:

• Aspirin
• NSAIDs
• Colchicine
• Steroids

Interventional:

• Pericardiocentesis
• Surgical drainage

Question 9

What is the name of the complication of pericardial effusion when the effusion becomes so large that it affects heart function?

Answer 9

Cardiac tamponade

Question 10

The presence of cardiac tamponade is suggested by Becks Triad… what is this?

Answer 10

Hypotension
Muffled HS
Raised JVP