Pericardial effusion physical examination: Difference between revisions
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{{Pericardial effusion}} | {{Pericardial effusion}} | ||
{{CMG}}; '''Associate Editor-In-Chief:''' [[Varun Kumar]], M.B.B.S. | {{CMG}}; '''Associate Editor-In-Chief:''' {{AIA}}, [[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]], h[[Hepatomegaly|epatomegaly]], [[ascites]] in chronic cases, and [[ankle edema]] in chronic cases | |||
==Physical examination== | ==Physical examination== | ||
The physical examination of patients with pericardial effusion may show the following <ref name="pmid28062268">{{cite journal| author=Vakamudi S, Ho N, Cremer PC| title=Pericardial Effusions: Causes, Diagnosis, and Management. | journal=Prog Cardiovasc Dis | year= 2017 | volume= 59 | issue= 4 | pages= 380-388 | pmid=28062268 | doi=10.1016/j.pcad.2016.12.009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28062268 }} </ref><ref name="pmid17661668">{{cite journal| author=Levy PY, Habib G, Collart F, Lepidi H, Raoult D| title=Etiological diagnosis of pericardial effusion. | journal=Future Microbiol | year= 2006 | volume= 1 | issue= 2 | pages= 229-39 | pmid=17661668 | doi=10.2217/17460913.1.2.229 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17661668 }} </ref><ref name="pmid25867671">{{cite journal| author=Frydman GH, Earl A| title=What is your diagnosis? Cardiovascular distress secondary to pericardial effusion. | journal=J Avian Med Surg | year= 2015 | volume= 29 | issue= 1 | pages= 75-8 | pmid=25867671 | doi=10.1647/1082-6742-29.1.75 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25867671 }} </ref>: | |||
=== Appearance of the patient === | |||
* Patients with mild cardiac effusions usually appear normal. | |||
* However, patients with large pericardial effusions usually appear distressed and uncomfortable. | |||
===Vital signs=== | |||
* [[Tachycardia]] | |||
* [[Pulsus paradoxus]] | |||
* Hypotension in [[cardiac tamponade]] | |||
=== Skin === | |||
* Skin examination of patients with pericardial effusion is usually normal. | |||
=== HEENT === | |||
* HEENT examination of patients with pericardial effusion is usually normal. | |||
=== Neck === | |||
* [[Jugular venous distension]] | |||
* Prominent Y descent | |||
* [[Kussmaul's sign]] | |||
===Lungs=== | |||
* Pleural dullness | |||
* Decreased breath sounds | |||
=== Heart === | |||
* Distant [[heart sounds]] | |||
===Abdomen=== | |||
* [[Hepatomegaly]] | |||
* [[Ascites]] in chronic cases | |||
=== Back === | |||
* Back examination of patients with pericardial effusion is usually normal. | |||
=== Genitourinary === | |||
* Genitourinary examination of patients with pericardial effusion is usually normal. | |||
=== Neuromuscular === | |||
* Neuromuscular examination of patients with pericardial effusion is usually normal. | |||
===Extremities=== | |||
* [[Ankle edema]] in chronic cases | |||
==References== | ==References== | ||
Latest revision as of 13:51, 9 March 2020
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Pericardial effusion Microchapters |
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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
Physical examination
The physical examination of patients with pericardial effusion may show the following [1][2][3]:
Appearance of the patient
- Patients with mild cardiac effusions usually appear normal.
- However, patients with large pericardial effusions usually appear distressed and uncomfortable.
Vital signs
- Tachycardia
- Pulsus paradoxus
- Hypotension in cardiac tamponade
Skin
- Skin examination of patients with pericardial effusion is usually normal.
HEENT
- HEENT examination of patients with pericardial effusion is usually normal.
Neck
- Jugular venous distension
- Prominent Y descent
- Kussmaul's sign
Lungs
- Pleural dullness
- Decreased breath sounds
Heart
- Distant heart sounds
Abdomen
- Hepatomegaly
- Ascites in chronic cases
Back
- Back examination of patients with pericardial effusion is usually normal.
Genitourinary
- Genitourinary examination of patients with pericardial effusion is usually normal.
Neuromuscular
- Neuromuscular examination of patients with pericardial effusion is usually normal.
Extremities
- Ankle edema in chronic cases
References
- ↑ 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:10.2217/17460913.1.2.229. 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.