Fast Five Quiz: Can You Recognize Subtle and Surprising Signs of Heart Conditions?

Yasmine S. Ali, MD, MSci

Disclosures

July 11, 2017

Cardiovascular symptoms in pericardial effusion can include the following:

  • Chest pain, pressure, discomfort: Characteristically, pericardial pain may be relieved by sitting up and leaning forward and is intensified by lying supine.

  • Light-headedness, syncope

  • Palpitations

Respiratory symptoms can include the following:

  • Cough

  • Dyspnea

  • Hoarseness

Neurologic symptoms of pericardial effusion can include anxiety and confusion, whereas hiccups may occur as a GI symptom.

Pericardial friction rub, the most important physical sign of acute pericarditis, may have up to three components per cardiac cycle and is high-pitched, scratching, and grating. It can sometimes be elicited only when firm pressure with the diaphragm of the stethoscope is applied to the chest wall at the left lower sternal border. The pericardial friction rub is heard most frequently during expiration with the patient upright and leaning forward.

Respiratory findings can include the following:

  • Tachypnea

  • Decreased breath sounds, secondary to pleural effusions

  • Ewart sign: dullness to percussion beneath the angle of left scapula from compression of the left lung by pericardial fluid

For more on the presentation of pericardial effusion, read here.

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