Pericardial effusion electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Overview

The EKG in patients with pericardial effusion may demonstrate low voltages (micro-voltages or short QRS complexes) and electrical alternans.

Electrical alternans is an electrocardiographic phenomenon of alternation of QRS complex amplitude or axis between beats. It is seen in cardiac tamponade and or pericardial effusion and is thought to be related to changes in the ventricular electrical axis due to fluid in the pericardium.

The presence of micro-voltage and electrical alternans suggests pericardial effusion and or cardiac tamponade.

Electrocardiographic Examples

An ECG showing electrical alternans in a person with pericardial effusion. Note the beat to beat change in the height and axis of the QRS complexes.

An ECG showing electrical alternans in a person with pericardial effusion. Note the beat to beat change in the height and axis of the QRS complexes.

An example of electrical alternans. Note the beat to beat change in the height and axis of the QRS complexes.