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Related Experiment Videos

Electrocardiographic changes in pericardial effusion

D G Meyers1, R G Bagin, J F Levene

  • 1Department of Internal Medicine, University of Nebraska Medical Center, Omaha.

Chest
|November 1, 1993
PubMed
Summary

Electrocardiogram (ECG) changes are subtle and unreliable for detecting pericardial effusion. This study found ECG findings insufficient to diagnose pericardial effusion, highlighting limitations in current diagnostic methods.

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Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Medical Electrography

Background:

  • Textbook descriptions of ECG changes in pericardial effusion are based on limited human and animal data.
  • Commonly cited ECG changes include low QRS voltage, electrical alternans, P wave changes, and T wave inversion.

Purpose of the Study:

  • To investigate the association between electrocardiogram (ECG) changes and the presence of pericardial effusion.
  • To evaluate the diagnostic utility of ECG findings for pericardial effusion.

Main Methods:

  • A case-control study involving 46 patients with and 46 without pericardial effusion, confirmed by echocardiography.
  • Two temporally separate ECGs were obtained for patients with effusion (during absence and presence).
  • ECG variables were measured by blinded investigators, and effusion size was classified.

Main Results:

  • In repeated-measures analysis, only increased heart rate and QRS voltage < 0.5 mV were associated with effusion development.
  • A weak correlation was found between QRS voltage and effusion size; electrical alternans was rare.
  • Case-control comparison showed differences in heart rate and QRS voltage, but no ECG variable was sensitive for effusion detection.

Conclusions:

  • ECG findings are too few, subtle, insensitive, and nonspecific to be useful indicators of pericardial effusion.
  • Current ECG criteria have limited diagnostic value for pericardial effusion.

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