Pericardial effusion physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Abdelrahman Ibrahim Abushouk, MD [2], Varun Kumar, M.B.B.S.

Overview

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 ^[1]^[2]^[3]:

Patients with mild cardiac effusions usually appear normal.
However, patients with large pericardial effusions usually appear distressed and uncomfortable.

Genitourinary examination of patients with pericardial effusion is usually normal.

Neuromuscular examination of patients with pericardial effusion is usually normal.