The incidence of pericardial effusions as it relates to cardiac disease, rheumatologic disease, and post-operatively is well documented. However, through educational ultrasound screening in the ED, we have found a significant number of patients with pericardial effusions that have no related disease history. This can be problematic for physicians in the ED, as the diagnosis of a pericardial effusion could be the etiology of the patients symptoms and require prompt treatment. With the advances in ultrasound technology in recent years, bedside echocardiography is utilized multiple times a day in the ED, and establishing a baseline understanding of prevalence will prove useful for future ED physicians. We propose an analysis of patients 18-65 years of age with pericardial effusions to determine the prevalence of incidental or undiagnosed pericardial effusions in the population. This study would serve as a foundation to further research and possible changes in initial assessments of patients with chest pain, shortness of breath, or other cardiopulmonary complaints.

I) Perform a literature review on incidence of pericardial effusions in patients age 18-65, the disease state or surgeries most commonly associated, and prevalence of incidental pericardial effusions

II) Develop an Institutional Review Board (IRB) submission for retrospective review of all bedside cardiac ultrasounds (ECHO) for evaluation of pericardial effusions and their characteristics

III) Review collated ultrasound studies for positive studies evaluating pericardial effusion and document MRNs, demographic information, formal ECHO and diagnostic procedures performed and discharge diagnosis

IV) Data Analysis on patients with pericardial effusion, their ultrasounds and hospital course

V) Write an Abstract and Manuscript for National or Regional Presentation and high impact-factor journal submission.

VI) Fulfill all SRP requirements including oral presentation and manuscript development in a timely fashion

Students involved in this project will be part of a team of ED clinicians working to investigate pericardial effusions diagnosed by beside ultrasound in the ED, determining chronicity, etiology and mortality based on chart analysis and develop an abstract and manuscript for publication & presentation. Students will work with residents and attending physicians to first review all ultrasound images and documented findings, categorize positive studies and evaluate their workup, past medical history, diagnoses and mortality. The student will work to develop an IRB for approval, become proficient in data collection and analysis, and work with the research mentor on developing an oral presentation and manuscript. We will also work to submit both of these to local/national conferences and high-impact factor journals for publication.

Access to EPIC for medical chart review

Microsoft Excel

Weekly Ultrasound Lectures with Dr. Hafez