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ECG Disease Patterns

Pericardial Effusions on ECG

February 15th, 2021


Pericardial effusions tend to cause ECG changes only when they are massive, and ECG changes are a poor indicator of pericardial effusions overall.
The classical ECG changes in pericardial effusion are sinus tachycardia, low QRS voltage and electrical alternans.
  • ECG Findings in Pericardial Effusion

  • Sinus tachycardia
  • Low voltage (reduced QRS amplitude)
  • Electrical alternans - variation of the QRS amplitude between beats (thought to be due to swinging of the heart while suspended in fluid)
  • Examples

  • A low voltage ECG trace
  • A low voltage ECG trace
  • Electrical alternans
  • Electrical alternans
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