Pericardial Effusion

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)