Electrocardiographic Findings and Left Ventricular Function According to the Amount of Pericardial Effusion Measured by Echocardiography

ABSTRACT

Clinical findings, electrocardiographic voltage and left ventricular function were evaluated in 104 patients with percardial effusion. Patients were classified into three groups by the amounts of pericardial effusion measured by two-dimensional echocardiography. 49 patients had small pericardial effusion, 31 moderate effusion and 24 large effusion. In 47 patients the effusions were clinically unsuspected prior to echocardiographic examination. Pericardial friction rub was noted in 14 patients, two-thirds of whom had moderate to large effusions. There was no relationship between the size of effusion and the presence of friction rub. Total QRS amplitudes were lower in patients with moderate to large effusions than those in control group. Maximum diastolic endocardial velocity(DEVM) and E-F slope of the anterior mitral leaflet were decreased significantly in patients with moderate to large effusions as compared with those with small effusions. As a result, authors concluded that reduction in the QRS voltages in serial ECGs may suggest the presence and the amount of pericardial effusion and also DEVM and E-F slope of the anterior mitral leaflet can be sensitive measures of left ventricular relaxation in patients with pericardial effusion.