Electrocardiography – Pericarditis, Pericardial Effusion and Cardiac Tamponade

Abstract

Patients with pericardial effusions may quickly progress to cardiac tamponade. These conditions are often difficult to d iagnose, although physical examination and chest radiography are known to be poorly diagnostic of pericardial effusion. Advanced imaging techniques can accurately detect and quantify the size of pericard ial effusions. Unfortunately, these advanced techniques are expensive and are often not feasible as screening tests for pericardial effusion. In contrast, 12-lead electrocard iogram is inexpensive and is easily performed, but to our knowledge, its diagnostic value for pericardial effusion and cardiac tamponade has not been systematically examined. Pericarditis, pericardial effusion, and cardiac tamponade are associated with various electrocardiographic signs. Lo w voltage, PR segment depression, ST-T changes and electrical alternans have each been diagnostic of pericardial effusion and / or cardiac tamponade. However, many of the studies that previously investigated these electrocardiographic signs examined patient populations. The diagnostic value of 12-lead electrocardiogram for pericarditis, pericard ial effusion and cardiac tamponade has been reviewed in this article.