Pericardial effusion

                 Normal sac contains 50ml

Causes-

Infective pericarditis(Bacterial and viral) 
TB 
SLE/Rheumatoid arthritis 
Post myocardial infarction/Dressler syndrome 
Neoplasm 
Trauma

Signs-(or temponade or constrictive pericarditis) 

Tachycardia (If low volume and  pulsus paradoxus->Then it is tamponade)
Raised JVP(Kussmaul sign positive-Raised JVP during inspiration) 
Low blood pressure
Impalpable apex 
Cardiac dullness increased 
Soft heart sound 
Bronchial breath sound at inferior angle of scapula(Ewart sign-Due to compression of left  lung base by heart) 
Pericardial knock(3rd heart sound) , ascitis only in constrictive pericarditis

Investigation- 

CXR-PA view-Heart shadow enlarged , pear shaped and globular with oilgemic lung field 
FBC-ESR rise in TB/SLE 
ECG-Low voltage tracing and tachycardia 
Echocardiogram-Echo free zone 
Pericardiocentesis-Definitive investigation

Note: 
 
Recurrent pericarditis-Malignancy ,uremia

Pericardial temponade-Compression of heart by rapidly developing pericardial effusion due to trauma ,mailgnancy ,dissecting aneurysm

Huge cardiomegaly-Pericardial effusion ,multiple valvular disease ,dilated cardiomyopathy

Cardiogenic shock-Same features as other shock[Different shock is septic shock}

Traits	Constrictive pericarditis	Restrictive cardiomyopathy
Apex beat	Not felt	Felt
Heart	Pericardial knock	LVH/LVF maybe
Echo	Thick calcific pericardium	Thick myocardium
CT scan	Thick pericardium	Thick ventricle