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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]
Patients with pericardial effusion may have unremarkable physical exams but often present with tachycardia, distant heart sounds and tachypnea. [5] A physical finding specific to pericardial effusion is dullness to percussion, bronchial breath sounds and egophony over the inferior angle of the left scapula.
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]
On a chest X-ray, the normal heart silhouette should have a clear and defined outline. However, in cases of pericardial effusion, the accumulation of fluid within the pericardial sac causes the heart to appear enlarged and assumes a shape that is reminiscent of a water bottle, with relatively smooth cardiac contours. [ 2 ]
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)
Reference ranges (reference intervals) for blood tests are sets of values used by a health professional to interpret a set of medical test results from blood samples. Reference ranges for blood tests are studied within the field of clinical chemistry (also known as "clinical biochemistry", "chemical pathology" or "pure blood chemistry"), the ...
Pulsus paradoxus is not related to pulse rate or heart rate, and it is not a paradoxical rise in systolic pressure. Normally, blood pressure drops less precipitously than 10 mmHg during inhalation. Pulsus paradoxus is a sign that is indicative of several conditions, most commonly pericardial effusion. [1]
Uremic pericarditis is associated with azotemia, and occurs in about 6-10% of kidney failure patients. BUN is normally >60 mg/dL (normal is 7–20 mg/dL). However, the degree of pericarditis does not correlate with the degree of serum BUN or creatinine elevation. The pathogenesis is poorly understood. [2]