Pericardial effusion

an acute accumulation of serous fluid in the pericardiac sac, which is located between the visceral (epicardial) layer and fibrous/parietal layer of the serious pericardium

may be a transudate or exudate (2° pericardial injury)

Serosanguineous pericardial fluid = TB, malignancy

Frank blood = aortic aneurysm or dissection; penetrating trauma, wall rupture in AMI, bleeding due to coagulation defects

Dx

Beck's triad (hypotension + raised JVP + muffled Ht. sounds)

Echo

electrical alternans

CXR - water bottle appearance if large amount of water in it

Cardiac tamponade

rapid development of pericardial effusion

the heart cannot expands to accomodate as in chronic pericardial effusion and so being compressed

can occur as a sequale of pericarditis

S/S

dyspnea, fatigue, and orthopnea

Neck vein distension with clear lung