Why does pericardial effusion reduce the pulse pressure difference?

Written by Di Zhi Yong
Cardiology
Updated on September 10, 2024
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Pericardial effusion can result in reduced pulse pressure differences between systolic and diastolic pressures. This occurs because pericardial effusion can compromise the heart's pumping function, leading to decreased myocardial contractility, which in turn may lead to excessive vascular pressure and a decrease in pulse pressure. This is a pathological change caused by pericardial effusion. Currently, in treatment, medication can be chosen to improve patient's cardiac function and thereby increase cardiac output. It is also important to actively treat the pericardial effusion, which may involve pericardiocentesis to drain the fluid and check pressures, as this can also alleviate reduced pulse pressure issues.

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Written by Li Hai Wen
Cardiology
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Is pericardial effusion hereditary?

Pericardial effusion is not hereditary. Pericardial effusion is not a genetic disease, and the causes of pericardial effusion are often acquired factors. For example, tuberculosis infection can cause tuberculous pericarditis, leading to pericardial effusion. Symptoms often include unexplained low-grade fever, cough, and night sweats, with a PPD test often showing a rigid change. Pericardial effusion caused by heart failure often presents with repeated exertional dyspnea, accompanied by limb edema. Cardiac ultrasound often reveals changes in the heart structure, such as cardiac enlargement and reduced cardiac pumping function. Additionally, hypoalbuminemia and tumors can also cause pericardial effusion, but these factors are not related to genetics.

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Written by Di Zhi Yong
Cardiology
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Can pericardial effusion be aspirated?

Pericardial effusion can be treated with percutaneous fluid drainage, particularly in cases where there is a significant amount of fluid. However, for minor effusions, it is advisable that patients temporarily observe their condition and focus on symptomatic treatment. These small amounts of pericardial effusion can be absorbed naturally, and this typically pertains to milder cases. It is also recommended that patients regularly visit the hospital for echocardiography to monitor their condition. If the pericardial effusion does not fully resolve, fluid drainage may sometimes be necessary to alleviate the patient's current condition, as this fluid generally represents an inflammatory exudative change.

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Written by Cai Li E
Cardiology
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Why does pericardial effusion cause abnormal pulses?

Pulsus paradoxus refers to a condition where the pulse weakens significantly or disappears during inhalation, caused by a decrease in the left ventricular stroke volume. Normally, the strength of the pulse is not affected by the respiratory cycle. However, when cardiac tamponade, significant pericardial effusion, or constrictive pericarditis occurs, inhalation can restrict the relaxation of the right heart, leading to a reduced volume of blood returning to the heart and affecting the right heart’s output. Consequently, the amount of blood the right ventricle pumps into the pulmonary circulation is reduced. Furthermore, the pulmonary circulation is affected by the negative thoracic pressure during inhalation, causing pulmonary vessels to dilate and reducing the volume of blood returning from the pulmonary veins to the left atrium. Therefore, the output of the left heart also decreases. These factors lead to a weakened pulse during inhalation, which can sometimes be imperceptible, also known as pulsus paradoxus. This condition can be identified by a significant drop in systolic pressure by more than 10mmHg during inhalation compared to exhalation.

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Written by Li Hai Wen
Cardiology
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Can pericardial effusion be drained?

In cases of moderate or large pericardial effusion, fluid can be drained, such as when the thickness of the pericardial effusion exceeds two centimeters. Draining the fluid can relieve the symptoms caused by the pericardial effusion, improve cardiac blood supply, and also allow for the collection of samples for routine and biochemical analysis of the effusion, as well as pathological examination. By analyzing the drained fluid, it is possible to determine the nature of the effusion, such as whether it is an exudate or a transudate. This can then further help in determining the cause of the effusion, where exudates are often caused by factors such as tuberculosis and cancer, while transudates are often due to heart failure or hypoproteinemia and other factors.

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Cardiology
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Pericardial effusion tracheal shift to which side?

If a patient presents with pericardial effusion, normally the trachea is displaced laterally, but specific circumstances can determine this. For minor or moderate amounts of pericardial effusion, the current treatment primarily involves pericardiocentesis to drain the fluid; symptomatic treatment is predominantly used. During this period, it is also important to monitor changes in the patient's heart rate, blood pressure, and pulse. If the patient experiences a rapid heart rate and increased blood pressure, these conditions need to be actively managed. Early use of cardiotonic diuretics can help alleviate respiratory distress, wheezing, or shortness of breath after activity caused by the pericardial effusion. Regular cardiac echocardiography check-ups are also recommended for the patient.