How I Treat... Pericardial Effusion

INTRODUCTION

Pericardial Effusion (PE) refers to the accumulation of fluid in the pericardial sac and can be caused by several etiologies, including cardiac neoplasia, infectious and inflammatory disorders, heart failure and congenital abnormalities, such as peritoneo-pericardial hernia. Common neoplastic conditions of the pericardium include hemangiosarcoma (HAS), chemodectomas, mesotheliomas and lymphomas. The signs of PE depend from the pressure that develops inside the pericardial sac due to the excessive fluid accumulation. Because the pericardium is relatively noncompliant, any increase on its volume can sharply increase intrapericardial pressure (IPP). Pericardium compliance and most importantly from the speed of fluid accumulation in the pericardial sac also affect (IPP). Pericardial tamponade (PT) is a condition where the intrapericardial pressure equals or exceeds the cardiac filling pressures, interfering with cardiac diastole and systole, impending venous return and decreasing cardiac output. If not treated, PT can become fatal.

CLINICAL PRESENTATION

PT is relatively common in dogs and rare and cats. Patient´s signaling mainly reflects the underlying etiology. The clinical presentation is suggestive of a state characterized by poor cardiac output and systemic venous congestion. Weakness, tachypnea, syncope, lethargy, poor exercise intolerance, inappetence, cough and ascites are common. Depending of the underlying cause others may also be evident (e.g. cachexia in neoplasia).  […]