Electrocardiography – Pericarditis, Pericardial Effusion and Cardiac Tamponade

Patients with pericardial effusions may quickly progress to cardiac tamponade. These conditions are often difficult to diagnose, although physical examination and chest radiography are known to be poorly diagnostic of pericardial effusion. Advanced imaging techniques can accurately detect and quantify the size of pericardial effusions. Unfortunately, these advanced techniques are expensive and are often not feasible as screening tests for pericardial effusion. In contrast, 12-lead electrocardiogram is inexpensive and is easily performed, but to our knowledge, its diagnostic value for pericardial effusion and cardiac tamponade has not been systematically examined. Pericarditis, pericardial effusion, and cardiac tamponade are associated with various electrocardiographic signs. Low voltage, PR segment depression, ST-T changes and electrical alternans have each been diagnostic of pericardial effusion and /or cardiac tamponade. However, many of the studies that previously investigated these electrocardiographic signs examined patient populations. The diagnostic value of 12-lead electrocardiogram for pericarditis, pericardial effusion and cardiac tamponade has been reviewed in this article.