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Pericardial effusion: Difference between revisions
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* Jugular venous congestion | * Jugular venous congestion | ||
* Pulsus paradoxus | * Pulsus paradoxus | ||
Pulsus paradoxus refers to when the systolic blood pressure decreases by more than 10 mmHg during inspirasjon compared to during expiration. This occus because the (physiological) increased filling of the right ventricle impairs the filling of the left ventricle, as the pericardium is non-compliant and therefore prevents the left ventricle from expanding. This can be measured directly with manual blood pressure measurement. The name "paradoxus" comes from the fact that during inspiration the pulse wave amplitude decreases, meansing that during inspiration some beats cannot be felt on the radial pulse. | Pulsus paradoxus refers to when the systolic blood pressure decreases by more than 10 mmHg during inspirasjon compared to during expiration. This occus because the (physiological) increased filling of the right ventricle impairs the filling of the left ventricle, as the pericardium is non-compliant and therefore prevents the left ventricle from expanding. This can be measured directly with manual blood pressure measurement. The name "paradoxus" comes from the fact that during inspiration the pulse wave amplitude decreases, meansing that during inspiration some beats cannot be felt on the radial pulse.<section begin="radiology" /> | ||
<section begin="radiology" /> | |||
== Diagnosis and evaluation == | == Diagnosis and evaluation == | ||
A [[chest x-ray]] may not always show a pericardial effusion. The cardiac shadow may be enlarged. If the effusion is large enough, the heart may appear water bottle-shaped, called "water bottle sign". Echocardiography is the investigation best suited to evaluate pericardial effusion, as it will directly visualise the anechoic fluid around the heart. The effusion is mild when < 10 mm on echo, severe when > 20 mm, and moderate in between. | A [[chest x-ray]] may not always show a pericardial effusion. The cardiac shadow may be enlarged. If the effusion is large enough, the heart may appear water bottle-shaped, called "water bottle sign". Echocardiography is the investigation best suited to evaluate pericardial effusion, as it will directly visualise the anechoic fluid around the heart. The effusion is mild when < 10 mm on echo, severe when > 20 mm, and moderate in between. | ||