Difference between revisions of "Pericardial Effusion"

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[[Category:Cardiac Diseases - Dog]][[Category:Cardiac Diseases - Cat]]
 
[[Category:Cardiac Diseases - Dog]][[Category:Cardiac Diseases - Cat]]
 
[[Category:Cardiac Diseases - Horse]]
 
[[Category:Cardiac Diseases - Horse]]
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[[Category:Cardiac Diseases - Pig]]

Revision as of 19:24, 17 January 2011

Most common pericardial disease (dogs & cats)

Signalment

Age: 5 years +

Genetics & Predisposed Breeds: Large Breeds (German Shepherd, Golden Retriever); Brachycephalic Breeds


Description

  • Accumulation of fluid in the pericardial sac as the result of a pathological process. The three types of pericardial effusions possible are hemorrhagic, exudative, and transudative. The type of effusion helps to determine the disease process.


-Hemorrhagic Effusions: Neoplasia, Trauma, Idiopathic


-Transudative Effusions: Hypoproteinemia


-Exudative Effusions: Infections, Uremia, Idiopathic


  • As the pericardial effusion accumulates, the increased pressure within the pericardial sac compresses the thin walled, lower pressure right ventricle decreasing its diastolic filling capacity. Consequently right sided congestive heart failure develops.


Diagnosis

History & Clinical Signs

-Exercise intolerance

-Weakness

-Lethargy

-Signs of right-sided heart failure (e.g. ascites, dyspnoea, hepatomegaly)

-Jugular Distension/Pulses

-Pulsus Paradoxus

-Pale Mucus Membranes

-Capillary Refill Time > 3 sec


Physical Exam

-Muffled Heart Sounds

-Decreased Respiratory Sounds

-Tachycardia


Radiography

-Enlarged, rounded cardiac silhouette

-Signs of right-sided heart failure:

  • ascites
  • pleural effusion
  • distension of the caudal vena cava
  • hepatomegaly


Electrocardiography (ECG)

Pericardial Effusions:

-short R wave

-tall ST wave


Echocardiography

-Fluid +

-Right-side heart collapse during diastole (cardiac tamponade)

-Neoplasia +/-

-Reduction in right heart size


Treatment

-Pericardiocentesis:

  • Curative or palliative depending on the underlying cause of the effusion

-Pericardiectomy (recurrent idiopathic effusion)

-Surgical Removal (foreign bodies)

Prognosis

-Good (idiopathic effusion, foreign bodies)

-Poor (neoplasia)