Pericardial Effusions on ECG
Overview
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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