1. Pericardial disease
Pericardial effusion
Cardiac tamponade
Constrictive pericarditis

2. Pericardial effusion
 Abnormal accumulation of fluid in pericardial
cavity (normal- 15-50 ml)
 Types & causes-
 Transudative- HF, myxedema, nephrotic syndrome
 Exudative- TB, viral infection, SLE, post-MI/CABG
 Hemorrhagic- trauma, rupture, malignant
 s/s- chest pain/pressure, muffled heart
sounds
 CxR- enlarged ‘water-bottle heart’
 ECG- low voltage, atrial arrythmias
 Rx- of underlying disease, drain if required

3. Cardiac tamponade
 Sudden or significant fluid accumulation in pericardial
cavity
 Causes impaired ventricular filling, leading to low
stroke volume
 Signs- hypotension, raised JVP, muffled heart sounds
 ± pulsus paradoxus- drop in systolic BP of >10 mm
Hg on inspiration
 May present as PEA or shock
 Dx- ECG, ECHO
 Rx- pericardiocentesis

4. Constrictive pericarditis
 A late sequelae of pericarditis
 Commonest cause- TB
 Results in impaired ventricular filling
 s/s- fatigue, fluid retention, raised JVP, rapid
y descent, Kussmaul sign– raised JVP on
inspiration
 CxR- pericardial calcification
 Dx- ECHO/MRI
 Rx- diuretics, surgical pericardial stripping