Pericardial effusion presentation.. pptx

this presentation is on pericardial effusion. The content in this presentation is the definition, natural history, signs and symptoms, clinical presentation, pathophysiology, diagnosis and treatment of pericardial effusion.

1. PERICARDIAL EFFUSION PRESENTED BY :CHINMAYI KALOKHE

2. DEFINATION Pericardial effusion is defined as the excess accumulation of fluid in the pericardium .  It can happen for many reasons, like infections, injuries or other medical conditions.

3. SIGNS AND SYMPTOMS The main symptoms of pericardial effusions and cardiac tamponade include:  Shortness of breath (dyspnea) .  Chest pressure or  pain .  Fast heartbeat or  heart palpitations .  Lightheadedness or dizziness .  Fainting (syncope) .  Fatigue .  Anxiety, confusion or other behavior changes (because of low blood flow to your brain).  Cyanosis  (a blue or gray tinge to your lips or under your fingernails that happens when you have low blood oxygen levels). If a pericardial effusion is large enough, it can press on surrounding tissues or nerves. That can cause symptoms like:  Trouble swallowing (dysphagia) .  Hiccups .  Coughing or hoarseness.

4. NATURAL HISTORY Asymptomatic effusion: Small effusions may be asymptomatic and resolve on their own without treatment. Gradual accumulation: Effusions can accumulate gradually over time, allowing the pericardium to stretch and accommodate the excess fluid Rapid accumulation: Rapid accumulation of fluid can lead to cardiac tamponade, a life-threatening condition that requires immediate attention. Chronic effusion: Chronic effusions can lead to fibrosis and adhesion of the pericardium, which can impair cardiac function.5. Recurrent effusion: Some patients may experience recurrent effusions, which can be challenging to manage.

5. PATHOPHYSIOLOGY Increased production: Inflammation:  Following viral, bacterial, or autoimmune pericarditis, local capillary permeability increases, allowing protein-rich exudate to accumulate. Malignancy:   Tumor  invasion or inflammation of the pericardium enhances local fluid exudation. Trauma or surgical intervention:  Injury to pericardial vessels can cause  hemorrhagic  effusions. Decreased drainage: Obstruction of pericardial lymphatics  can occur in malignancy, mediastinal fibrosis, or hypothyroidism. Elevated venous pressures  in heart failure or renal failure reduce reabsorption. Hydrostatic and oncotic imbalance: Conditions like cirrhosis, nephrotic syndrome, or hypoalbuminemia decrease plasma oncotic pressure,  favoring  transudative fluid accumulation. Hydrostatic pressure pushes fluid out of capillaries , while oncotic pressure pulls fluid back in ; in pleural effusion ,am imbalance between these pressure often due to conditions like HF,cirrhosis

6. CLINICAL PRESENTATION Pericardial effusion can present variably, ranging from asymptomatic cases to life-threatening cardiac tamponade, depending on the volume and rate of fluid accumulation. Symptoms The clinical presentation depends on  how rapidly the fluid accumulates  and the  total volume : Cardiovascular symptoms : Chest pain or pressure, typically  relieved by sitting up and leaning forward  and worsened when lying down; palpitations; light-headedness or syncope, especially if cardiac output is compromised  2 . Respiratory symptoms : Dyspnea on exertion, orthopnea, cough, or hoarseness due to compression  2 . Gastrointestinal and neurologic symptoms : Nausea, dysphagia, anxiety, confusion, or hiccups may occur, particularly in large or rapidly accumulating effusions  2 . Asymptomatic presentations : Many pericardial effusions, especially small or slowly accumulating ones, are found incidentally on imaging studies

7. DIAGNOSIS  1)imaging tests like:  Echocardiogram .  Chest X-ray .  Computed tomography (CT) scan  of your chest.  MRI of your heart . 2)The possible tests include:  Complete blood count  (CBC).  Troponin .  B-type natriuretic peptide .  Thyroid-stimulating hormone .  Immune system tests (to look for  immune system  disorders or inflammatory conditions)

8. MANEGMENT AND TREATMENT The pericardial effusion treatment you get depends on how severe your condition is and what caused it. If you have a small or medium-sized pericardial effusion that’s shrinking or not changing size, and you don’t have symptoms, you may not need any treatment. In these cases, your healthcare provider will probably want to monitor the effusion size and only treat it if you develop symptoms or if there are other signs that it might be a problem. If you have an effusion that’s growing more quickly, that’s causing symptoms or that’s happening because of more serious conditions (especially trauma or cancer), you’ll probably need treatment sooner rather than later.

9. When a pericardial effusion is large or causes cardiac tamponade, it becomes a medical emergency that needs immediate treatment. Unlike smaller amounts, the pericardial fluid won’t go away unless you remove it. Potential treatments include: Needle aspiration ( pericardiocentesis ) : After numbing a specific area on your chest and using imaging (like echocardiography or   fluoroscopy ) for guidance, a healthcare provider will insert a needle into your chest until it’s just inside your pericardium. Then, they’ll aspirate (pull out) the excess fluid inside. They may leave a thin, tube-like device inside your pericardium to drain fluid for a few days until it’s all gone. Surgery : In some cases, surgery is the best way to remove the extra fluid inside your pericardium. You may have emergency surgery or a scheduled procedure (when an effusion causes symptoms but is slow-growing and not dangerous). A common surgical procedure for this is  video-assisted thoracic surgery (VATS) . This creates a pericardial “window” to allow draining fluid to spill into the larger pleural cavity so it doesn’t fill up the pericardial space

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