Massive pericardial effusion produces a triad of…
- Low voltage
- Electrical alternans
Electrical alternans is…
- when consecutive, normally-conducted QRS complexes alternate in height.
- produced by the heart swinging backwards and forwards within a large fluid-filled pericardium.
Patients with this ECG pattern need to be immediately assessed for clinical and echocardiographic evidence of tamponade.
Learn From The Experts!
Consolidate your learning with lessons from the masters of ECG interpretation. Follow the links below for expert commentary, video lessons, case-based discussion and detailed explanations to take your learning to the next level.
- Amal Mattu’s ECG Video of the week – Low voltage and pericardial effusion (video lessons)
- Dr Smith’s ECG Blog – Differential diagnosis of low QRS voltage (case discussion)
Take The Next Step.
You’ve made the ECG diagnosis, now what? Think beyond the ECG with lessons on advanced diagnosis and management.
- ECG BASICS – Waves, Intervals, Segments and Clinical Interpretation
- ECG CLINICAL CASES – Your favourite ECG’s placed in clinical context with a challenging Q&A approach
- ECG and Cardiology Eponymous Syndromes – Cheats guide to eponymous emancipation
- ECG Reference Sites on the WEB – the best of the rest
- Chan TC, Brady WJ, Harrigan RA, Ornato JP and Rosen PR. ECG in Emergency Medicine and Acute Care. Elsevier 2005
- Mattu A, Brady W. ECGs for the Emergency Physician 2, BMJ Books 2008.