Pericardial effusion physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. ; Associate Editor-In-Chief: Abdelrahman Ibrahim Abushouk, MD, Varun Kumar, M.B.B.S.
The vital signs of a patient with small pericardial effusion are often normal. Fever suggests an underlying infectious or inflammatory cause, and the presence of a purulent effusion must be ruled out. The common signs include tachycardia, pulsus paradoxus, hypotension in cardiac tamponade, jugular venous distension, prominent Y descent, Kussmaul's sign, pleural dullness, decreased breath sounds, distant heart sounds, hepatomegaly, ascites in chronic cases, and ankle edema in chronic cases
The physical examination of patients with pericardial effusion may show the following :
Appearance of the patient
- Patients with mild cardiac effusions usually appear normal.
- However, patients with large pericardial effusions usually appear distressed and uncomfortable.
- Pulsus paradoxus
- Hypotension in cardiac tamponade
- Skin examination of patients with pericardial effusion is usually normal.
- HEENT examination of patients with pericardial effusion is usually normal.
- Jugular venous distension
- Prominent Y descent
- Kussmaul's sign
- Pleural dullness
- Decreased breath sounds
- Distant heart sounds
- Ascites in chronic cases
- Back examination of patients with pericardial effusion is usually normal.
- Genitourinary examination of patients with pericardial effusion is usually normal.
- Neuromuscular examination of patients with pericardial effusion is usually normal.
- Ankle edema in chronic cases
- ↑ Vakamudi S, Ho N, Cremer PC (2017). "Pericardial Effusions: Causes, Diagnosis, and Management". Prog Cardiovasc Dis. 59 (4): 380–388. doi:10.1016/j.pcad.2016.12.009. PMID 28062268.
- ↑ Levy PY, Habib G, Collart F, Lepidi H, Raoult D (2006). "Etiological diagnosis of pericardial effusion". Future Microbiol. 1 (2): 229–39. doi:10.2217/174609220.127.116.11. PMID 17661668.
- ↑ Frydman GH, Earl A (2015). "What is your diagnosis? Cardiovascular distress secondary to pericardial effusion". J Avian Med Surg. 29 (1): 75–8. doi:10.1647/1082-6742-29.1.75. PMID 25867671.