Pericardial effusion: Difference between revisions
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* Pulsus parasoxus: decrease in SBP by 10+ on inspiration (<4 is normal) |
* Pulsus parasoxus: decrease in SBP by 10+ on inspiration (<4 is normal) |
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Latest revision as of 10:28, 16 July 2020
Clinical Manifestations
- Pulsus parasoxus: decrease in SBP by 10+ on inspiration (<4 is normal)
- Results from interventricular interdependence
- DDx includes asthma exacerbation
- Beck's triad
- Hypotension
- Increased JVP
- Distant heart sounds
- Lungs should be clear to auscultation
Investigations
- EKG shows low-voltage QRS (QRS < 1 big box in limbs leads or <2 big boxes in precordial leads)
- DDx includes COPD, hypothyroidism, cardiac amyloidosis, and pericardial effusion
Management
- Drain the fluid
- Ultrasound-guided pericardiocentesis
- Apical approach safer than subxiphoid
- Only need to remove 10-15mL fluid to relieve hypotension
- Pericardial window
- Ultrasound-guided pericardiocentesis
