Summary
Definition
History and exam
Key diagnostic factors
- malignancy
- presence of other risk factors
- dyspnoea
- elevated jugular venous pressure
- distant heart sounds
- pulsus paradoxus
- hypotension
- tachycardia
- recent invasive cardiac intervention procedure
Other diagnostic factors
- chest pain
- abdominal pain
- confusion
- fever
- pericardial rub
Risk factors
- malignancy
- aortic dissection
- purulent pericarditis
- large idiopathic pericardial effusion
- iatrogenic-related haemorrhage
- tuberculosis (TB)
- autoimmune disease
- hypothyroidism
- uraemia
- anticoagulation
Diagnostic investigations
1st investigations to order
- ECG
- transthoracic echocardiogram
- CXR
- FBC
- erythrocyte sedimentation rate
- cardiac enzymes
Investigations to consider
- cardiac catheterisation
- pericardiocentesis fluid for culture and cytology
Treatment algorithm
Contributors
Authors
Professor of Medicine
Division of Cardiology
University of California
San Francisco
CA
Disclosures
VSM declares that he is a proctor for Edwards Lifesciences for transcatheter valves and also a proctor for Abbott for closure devices.
Fellow in Structural Cardiac Intervention
University of California
San Francisco
CA
Disclosures
HA declares that he has no competing interests.
Dr Vaikom S. Mahadevan and Dr Harsh Agrawal would like to gratefully acknowledge Dr Jonathan Bella, Dr Liran Blum, and Dr Michael Spinelli, previous contributors to this topic.
Disclosures
JB, LB, and MS declare that they have no competing interests.
Peer reviewers
Professor of Medicine
Director of Echocardiography
Mayo Clinic
Jacksonville
FL
Disclosures
RC declares that he has no competing interests.
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