Pericardial Effusion and It's sign and symtom

Definition:
Collection Of free fluid in pericardial sac.
Normal amount -150 ml
clinical and radiologically detect -250ml
Types of Pericardial Effusion:
a. Transudate
b.Exudates- 1. Serous
2.Purulent
3. Hemorrhagic

Causes :
a. Trasudate:
-CCF
-Myxoedema
-Nephritic syndrome
-Wet Beri Beri
b. Exudate:
-Serous:
-Tuberculosis
-Myocardial infarction
-Uremia
-Rheumatic effusion
-SLE
-Connective Tissue Disease
-Purulent:
-Pyogenic infection
-staphylococci
-sterptococci
-pneumococci
-Burst mediastinal abcess, lung abcess, liver abcess into pericardial
sac
-Hemorrhagic:
- Myocardial infarction
- Malignancy
- Tuberculosis
- Stab injury or gun shot injury
-Ruptured of dissecting aneurysm or syphilitic aneurysm
-Rheumatic origin
Causes of smalll and large pericardial effusion:
a. Small :
- Initial phase of large effusion
- Heart failure
- Nephrotic syndrome
b. Large:
-Tuberculosis
-Malignancy
-Carcinoma
-Myxoedema
Symtom and Sign:
Symtom-
- no specific symtom
- Pain of pericarditis may disappear when effusion develops
-In hemorrhagic pericardial effusion there may be pain due to irrition to pericardium
-In large effusion substernal discomfort and may feel faint on sitting upright or on exertion
-Shortness of breath, palpitation
Sign-
- Small effusion does not give any specific sign
-Large effusion
a. Pulse-Tachycardia
b. Apex beat-Nor visible neither palpable
c. Increase cardiac dullness
d. Roth's Sign positive
e. Ewart's sign positive
f. on auscultation-
Faint heart sound
Pericardial friction rub may still be audible despite effusion
Bronchial breath sound beneath left scapula
Rales over lung field due to compression of lung field