Pericardial Effusion Flashcards
What 3 things happen as fluid accumulates in the pericardial sac?
- ability of the pericardium to stretch is exceeded
- volume and pressure within the pericardial space increases
- cardiac function is compromised secondary to decreased diastolic filling
What is cardiac tamponade? What 4 things does it impair?
form of cardiogenic shock that develops when the interpericardial pressure equals or exceeds right atrial pressure
- venous return
- ventricular filling
- stroke volume
- cardiac output
What neoplasms are most likely to cause pericardiac effusion in dogs and cats?
DOGS: HSA, chemodectoma, mesothelioma, LSA, thyroid carcinoma
CATS: LSA, carcinomas, HSA, aortic body tumors, FSA
Other than neoplasms, what are 5 common causes of pericardial effusion in dogs?
- right-sided heart failure
- atrial rupture
- coagulopathy (rodenticides)
- bacterial infections
- idiopathic
Other than neoplasms, what are 2 common causes of pericardial effusion in cats?
- congestive heart failure
- FIP
What are the 5 most common causes of pericardial effusion in horses?
- idiopathic
- extension of viral infections - equine viral arteritis, equine influenza
- septicemia
- extension of bacterial infection from lungs
- neoplasia
What is the most common cause of pericardial effusion in cattle?
ingestion and penetration of a foreign object (TRP/Hardware disease)
- FB settles in reticulum and may penetrate the reticulum and pericardium that lies just cranial to the reticulum
What are the 3 most common signs of pericardial effusion? What else may be seen?
- attenuated heart sounds - muffled form effusion around heart
- jugular vein distention - increased RA pressure
- poor peripheral pulse quality
fever, anorexia, depression, weight loss, dyspnea, abdominal distention (hepatomegaly, ascites), peripheral edema, colic, elevated HR and RR
What are 4 clinicopathologic findings indicative of pericardial effusion?
- anemia secondary to blood loss or chronic disease
- elevations of coagulation parameters
- pre-renal azotemmia
- pulsus paradoxus - exaggeration of normal inspiratory decrease in systolic blood pressure
What are 3 signs of pericardial effusion on radiographs?
- enlargement of cardiac silhouette (rounded appearance)
- pleural effusion and enlarged vena cava
- hepatomegaly or decreased abdominal detail due to ascites
What are 4 signs of pericardial effusion on ECG?
- sinus tachycardia
- ventricular premature contractions
- low voltage QRS complexes
- electrical alternans - alternating variation in R-wave amplitude
What is the gold standard in diagnosing pericardial effusion?
echocardiography –> anechoic fluid in pericardial space
What are 2 possible treatments for pericardial effusion in small animals?
- pericariocentesis - done immediately with cardiac tamponade
- chemotherapy - if underlying cause is a treatable neoplasm
What are 3 possible complications associated with pericardiocentesis?
- VPCs
- laceration of the coronary artery
- sudden death
When is a pericardiectomy preferred for treating pericardial effusion?
idiopathic pericardial effusion
How is pericardial effusion most commonly treated in horses?
placement of an indwelling chest tube into the pericardial sac and subsequent drainage and lavage of the pericardial space followed by local infusion of anitmicrobials
What is treatment of pericardial effusion like in cattle?
unrewarding –> treatment of Hardware disease is usually directed at salvage or short term survival with repeated pericardial drainage and lavage
