© 2004 by BMJ Publishing Group & British Cardiac Society
MINI-SYMPOSIUM
Pericardial effusion: haemodynamic spectrum
Correspondence to:
Correspondence to:
Ralph Shabetai
MD, VA Health Care System, Cardiology 111 A, La Jolla, CA 92161, USA; rshabetai@ucsd.edu
Keywords: pericardial effusion; haemodynamics
| The first 150 words of the full text of this article appear below. |
Haemodynamic abnormalities, caused by pericardial effusion, range from undetectable or mild, to life threatening, depending on the determinants discussed below. These include the rate at which the effusion accumulates and whether or not the pericardium is scarred and thus adds an element of constrictive pericarditis. Pericardial adhesions or organisation of the fluid can result in localised, and thus atypical, tamponade. Pericardial effusion is the cause of a number of distinct clinical and haemodynamic syndromes.
Fundamental to understanding their pathophysiology are the biomechanical properties of the pericardium. The pressure–volume relation of normal pericardium, after an initial short shallow portion that allows the pericardium to stretch slightly in response to physiological events, such as changes in posture or volume status, shows a minimal increase in pericardial pressure. Thereafter, the pressure increase is extremely steep. This J shaped curve1 indicates that a sudden increase in the volume of pericardial fluid can slightly stretch
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