Electrocardiographic voltage in pericardial effusion

Area of Science:

• Cardiology
• Diagnostic Imaging

Background:

• Pericardial effusion can present with non-specific electrocardiographic (ECG) findings.
• Low voltage on ECG is a recognized sign, but its diagnostic utility for pericardial effusion requires clarification.

Purpose of the Study:

• To evaluate the diagnostic value of low voltage on ECG for detecting pericardial effusion.
• To assess the relationship between pericardial effusion volume and ECG voltage.
• To determine if changes in ECG voltage after pericardiocentesis correlate with fluid removal.

Main Methods:

• Retrospective analysis of 122 patients categorized into three groups: confirmed pericardial effusion, low voltage on ECG, and those undergoing pericardiocentesis.
• Echocardiography was used to detect and quantify pericardial effusion.
• ECG voltage measurements were analyzed in relation to effusion presence and volume, and changes post-pericardiocentesis were recorded.

Main Results:

• No significant correlation was found between the volume of pericardial effusion and ECG voltage in patients with effusion.
• Only 36% of patients with low voltage on routine ECGs had demonstrable pericardial effusion.
• A significant increase in ECG voltage was observed after pericardiocentesis, correlating with the volume of fluid removed.

Conclusions:

• A single ECG exhibiting low voltage is not a reliable indicator for diagnosing pericardial effusion.
• Serial ECG monitoring showing a reduction in voltage may suggest the development of pericardial effusion.
• Changes in ECG voltage following pericardiocentesis provide objective evidence of fluid removal.