In today's VETgirl online veterinary CE podcast, we're going to talk about pericardial effusion -; from how to diagnose it, what the clinical signs are, and how to treat it! Most importantly, tune in to learn how to perform a successful pericardiocentesis (well, as best I can teach you via an audio podcast!). Pericardial effusion is a commonly diagnosed condition in dogs that results from the accumulation of fluid within the pericardial sac, which surrounds the heart. This accumulation of fluid can lead to “pressure on the heart” (in other words, cardiac tamponade), causing decreased FILLING of the heart and secondary decreased cardiac output, eventually resulting in signs of shock. The degree of pressure exerted by the pericardial effusion depends on the volume of the effusion, the rate of fluid accumulation, and the distensibility of the fibrous pericardium. Pericardial effusion can present in one of two ways, as acute cardiac tamponade, or as a more chronic accumulation of fluid. Acute pericardial effusion often has a small volume of pericardial effusion, let's say 50 to 100 ml in the pericardial sac, which causes marked intrapericardial pressure and cardiac tamponade. With more chronic cases, there is typically a slower accumulation of pericardial effusion, allowing the pericardial sac to stretch and accommodate a significantly larger amount of fluid before cardiac tamponade results. With chronic cardiac tamponade, we can see signs of heart failure. In most cases, we see right-sided heart failure with pericardial effusion, as right-sided diastolic pressure has to increase only a small amount (from a normal of 5 mm Hg to 10-15 mm Hg) to result in failure [1].
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