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Ben-Horin et al. (2005) studied the composition of pericardial fluid in patients undergoing open heart surgery. They found that the fluid is made up of a high concentration of lactate dehydrogenase (LDH), protein and lymphocytes. In a healthy adult there is up to 50 ml of clear, straw-coloured fluid. [3]
A pericardial effusion is an abnormal accumulation of fluid in the pericardial cavity. The pericardium is a two-part membrane surrounding the heart: the outer fibrous connective membrane and an inner two-layered serous membrane .
This places the heart in proximity to the chest wall for easier insertion of the needle into the pericardial sac. [5] [7] For patients that are awake, a local anaesthetic is applied. [8] A large needle is inserted through the skin of the chest into the pericardium, and the practitioner aspirates the pericardial effusion into a syringe. [6]
This allows for the detection of a pneumothorax with the absence of normal ‘lung-sliding’ and ‘comet-tail’ artifact (seen on the ultrasound screen). Compared with supine chest radiography , with CT or clinical course as the gold standard, bedside sonography has superior sensitivity (49–99% versus 27–75%), similar specificity (95 ...
Figure A shows the location of the heart and a normal heart and pericardium (the sac surrounding the heart). The inset image is an enlarged cross-section of the pericardium that shows its two layers of tissue and the fluid between the layers. Figure B shows the heart with pericarditis.
Pulsus paradoxus is a sign that is indicative of several conditions, most commonly pericardial effusion. [ 1 ] The paradox in pulsus paradoxus is that, on physical examination , one can detect beats on cardiac auscultation during inspiration that cannot be palpated at the radial pulse . [ 1 ]
Beck's triad is a collection of three medical signs associated with acute cardiac tamponade, a medical emergency when excessive fluid accumulates in the pericardial sac around the heart and impairs its ability to pump blood. The signs are low arterial blood pressure, distended neck veins, and distant, muffled heart sounds. [1]
Purulent Pericarditis; Echocardiogram showing pericardial effusion with signs of cardiac tamponade: Specialty: Cardiology: Symptoms: substernal chest pain (exacerbated supine and with breathing deeply), dyspnea, fever, rigors/chills, and cardiorespiratory signs (i.e., tachycardia, friction rub, pulsus paradoxus, pericardial effusion, cardiac tamponade, pleural effusion)