oa Cardiovascular Journal of Africa - Pericardial effusion - the diagnostic value of the electrocardiogram in the paediatric patient



Electrocardiograms (ECGs) are routinely performed on children suspected of having a pericardial effusion. When the amplitude of the QRS-complexes is 'normal' in size the ECG is reported to be normal and the diagnosis is usually excluded. Twenty-six ECGs of patients with proven pericardial effusions were analysed by two paediatric cardiologists. Twenty-five of these ECGs were abnormal. Most of the abnormalities were nonspecific ST-segment and T-wave abnormalities, which were not diagnostic of pericardial effusions. Low-amplitude QRS complexes were only found in 11 of the 26 children; this gives a sensitivity of 42%. The ECG as a single diagnostic tool is therefore of little value in children with pericardial effusions but may help to differentiate between them and children with enlarged hearts.


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