Pericardial effusion physical examination

The vital signs of a patient with small pericardial effusion are often normal. Fever suggests an underlying infectious or inflammatory cause, and the presence of a purulent effusion must be ruled out. The common signs include tachycardia, pulsus paradoxus, hypotension in cardiac tamponade, jugular venous distension, prominent Y descent, Kussmaul’s sign, pleural dullness, decreased breath sounds, distant heart sounds, hepatomegaly, ascites in chronic cases, and ankle edema in chronic cases

The physical examination of patients with pericardial effusion may show the following ^[1][2][3]:

• Patients with mild cardiac effusions usually appear normal.
• However, patients with large pericardial effusions usually appear distressed and uncomfortable.

• Tachycardia
• Pulsus paradoxus
• Hypotension in cardiac tamponade

• Skin examination of patients with pericardial effusion is usually normal.

• HEENT examination of patients with pericardial effusion is usually normal.

• Jugular venous distension
• Prominent Y descent
• Kussmaul’s sign

• Pleural dullness
• Decreased breath sounds

• Distant heart sounds

• Hepatomegaly
• Ascites in chronic cases

• Back examination of patients with pericardial effusion is usually normal.

• Genitourinary examination of patients with pericardial effusion is usually normal.

• Neuromuscular examination of patients with pericardial effusion is usually normal.

• Ankle edema in chronic cases

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