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Rapid fluid accumulation in severe cases can progress to cardiac tamponade, a life-threatening condition that demands immediate recognition and treatment. A patient presented twice with evolving cardiopulmonary symptoms, and bedside screening ultrasound identified a large effusion, prompting urgent referral and definitive management. The case highlights screening echocardiography’s value as a low-cost, rapid tool.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/prehospital-detection-of-a-large-pericardial-effusion-using-screening-sonography-a-case-report/429240/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/prehospital-detection-of-a-large-pericardial-effusion-using-screening-sonography-a-case-report/429240.png","ImageObject",300,407,{"name":92,"@type":93},"Lucas Martin","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why is pericardial effusion difficult to detect in prehospital and peripheral emergency care?","Question",{"text":113,"@type":114},"It often presents with nonspecific symptoms and lacks specific signs, while standard tests like ECG or chest radiography have limited sensitivity. Access to immediate echocardiography and cardiology support is also frequently delayed.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What symptoms led to the use of bedside screening ultrasound in this case?",{"text":118,"@type":114},"The patient returned twice within two days with central chest pain, low-grade fever, and progressively worsening dyspnea. Because symptoms persisted and evolved, a bedside ultrasound was performed.",{"name":120,"@type":111,"acceptedAnswer":121},"How did screening ultrasound influence patient management and outcomes?",{"text":122,"@type":114},"The ultrasound revealed a large pericardial effusion, enabling urgent referral to a central hospital where the diagnosis was confirmed and appropriate management was instituted. Early identification supported timely escalation of care.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},429240,1790740122,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Review began 11/24/2025  \nReview ended 12/02/2025  \nPublished 12/04/2025  \n© Copyright 2025  \nMiravent et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98471  \nOpen Access Case Report  \nPrehospital Detection of a Large Pericardial Effusion Using Screening Sonography: A Case Report  \nSergio Miravent 1, 2, Juan M. Ruiz 1, Narciso B. Molina 1, Carmen J. Bermejo 1, Catarina M. Mascarenhas 2  \n1. Basic Emergency Service, Algarve Local Health Unit, Vila Real de Santo António, PRT 2. Medical Imaging and Radiotherapy, School of Health, University of the Algarve, Faro, PRT  \nCorresponding author: Sergio Miravent, [miraventsergio@hotmail.com](miraventsergio@hotmail.com)  \nAbstract  \nPericardial effusion, although not uncommon in emergency contexts, poses detection and diagnostic challenges in prehospital and peripheral emergency settings where access to advanced imaging and specialist evaluation is limited. In its severe forms, rapid fluid accumulation may lead to cardiac tamponade, a life-threatening condition requiring immediate recognition and intervention. The clinical course is often insidious, and the progression of symptoms may easily be mistaken for other, more common pathologies, further complicating timely diagnosis. We report the case of a patient who presented twice within two days to a Basic Emergency Service with central chest pain of five days’ duration, low-grade fever, and subsequently worsening dyspnea. Given the persistence and evolution of symptoms, a bedside screening ultrasound was performed, which revealed a large pericardial effusion. The patient was urgently referred to a central hospital, where the diagnosis was confirmed, and appropriate management was instituted. This case illustrates the vital function of screening ultrasound in resource-limited environments: even when definitive treatment cannot be provided locally, early identification of critical findings supports timely referral and improves patient outcomes. Furthermore, the decision to employ or omit screening echocardiography in such contexts can significantly influence clinical pathways and ultimately alter patient prognosis, emphasizing its relevance as a low-cost, rapidly deployable screening tool, while also stressing that patient outcomes may depend on the availability of a trained sonographer/radiographer capable of performing the examination.  \nCategories: Cardiology, Radiology, Emergency Medicine  \nKeywords: emergency, pericardial effusion, screening, tamponade, ultrasound  \nIntroduction  \nPericardial effusion covers a wide spectrum of presentations, ranging from incidental findings on imaging to rapidly progressive, life-threatening tamponade. In emergency care, its recognition is particularly demanding because the condition often lacks specific signs [1], and conventional diagnostic tools such as electrocardiography or chest radiography provide limited sensitivity. The electrocardiogram (EKG) may show electrical alternans or low QRS voltage in multiple leads in the setting of large effusions or tamponade, but these findings are suboptimal for diagnostic purposes [2] . For chest radiography to depict  \na pericardial effusion, more than approximately 200 mL of fluid is typically required, so smaller yet clinically relevant effusions can remain occult [3] .  \nDiagnostic uncertainty contributes to a delay in the detection of pericardial effusions; many remain undiagnosed during initial evaluation and are only discovered once patients deteriorate or advanced imaging is performed [4] . In peripheral and prehospital services, where access to cardiology consultation and echocardiography is not immediate and requires transfer to a referral hospital nearly an hour away, the challenge is even greater.  \nScreening sonography of","cbCaii2bfKc3myKN","https://ap.wps.com/l/cbCaii2bfKc3myKN","pdf",1486635,"English","# Abstract\n## Case presentation and referral impact\n## Role of screening sonography in resource-limited settings\n# Introduction\n## Clinical challenges in emergency recognition\n## Diagnostic limitations of conventional tools\n## Screening ultrasound as a pragmatic solution\n## Echocardiographic criteria and effusion severity","[{\"question\":\"Why is pericardial effusion difficult to detect in prehospital and peripheral emergency care?\",\"answer\":\"It often presents with nonspecific symptoms and lacks specific signs, while standard tests like ECG or chest radiography have limited sensitivity. Access to immediate echocardiography and cardiology support is also frequently delayed.\"},{\"question\":\"What symptoms led to the use of bedside screening ultrasound in this case?\",\"answer\":\"The patient returned twice within two days with central chest pain, low-grade fever, and progressively worsening dyspnea. Because symptoms persisted and evolved, a bedside ultrasound was performed.\"},{\"question\":\"How did screening ultrasound influence patient management and outcomes?\",\"answer\":\"The ultrasound revealed a large pericardial effusion, enabling urgent referral to a central hospital where the diagnosis was confirmed and appropriate management was instituted. Early identification supported timely escalation of care.\"}]","Prehospital Detection of a Large Pericardial Effusion Using Screening Sonography - A Case Report | PDF",1790649210,18]