Pericarditis echocardiography
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Pericarditis Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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Pericarditis echocardiography On the Web |
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American Roentgen Ray Society Images of Pericarditis echocardiography |
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Risk calculators and risk factors for Pericarditis echocardiography |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.
Overview
The role of echocardiography in the evaluation of the patient with pericarditis is to chracterize the presence, size, location and hemodynamic impact of a pericardial effusion.
Echocardiography
- The American College of Cardiology (ACC), the American Heart Association (AHA), and the American Society of Echocardiography in its recommendations on Echocardiography gave strong recommendations for echocardiography in pericardial disease.
- Helps in diagnosing pericardial disease, hemodynamic parameters (pressure in different cardiac chambers)
- Two dimensional and Doppler echocardiography should be done in all suspected cases of cardiac tamponade and cardiac effusion.
- Follow up/sequential echocardiography for assessment of impending cardiac tamponade should be considered.
Advantages of Other Imaging Modalities
- Pericardial CT is the optimal technology to assess perciardial calcification
Pericardial effusion secondary to pericarditis is seen on echocardiogram as a large hypoechoic region surrounding the heart. A swinging motion of the heart with each beat may also be noted in the setting of cardiac tamponade. It is this swinging motion that gives rise to electrical alternans. Echocardiography demonstrates the collection of pericardial fluid. The best view to visualize a pericardial effusion is the subcostal view. Signs of more advanced tamponade include indentation of the atrium and ventricle, and in later stages collapse of these structures. The location of the fluid should be characterized so that the feasability and safety of pericardiocentesis can be assessed. For example, the location of the fluid should be characterized as either circumferential, posterior or anterior. The cm of fluid thickness should be characterized. The presence of loculations should be described. Usually pericardiocentesis can be performed if there is over 0.5 cm of anterior fluid.
Pericardial effusion and cardiac tamponade
In pericardial effusion, large hypoechoic regions are seen surrounding the heart with presence of oscillatory motion of heart.
The echocardiogram below demonstrates swinging motion of the heart in cardiac tamponade. {{#ev:youtube|U4xQ3-VRiNg}}
Echocardiography of heart with loculated pericardial effusion compressing the left ventricle. {{#ev:youtube|unnmmlCyyZM}}
Cardiac tamponade {{#ev:youtube|YWVI6rRTIzU}}
Cardiac tamponade {{#ev:youtube|_az8_V6bHE8}}
Left ventricular free wall rupture with cardiac tamponade {{#ev:youtube|g9TdKcFRiLo}}
Collapse of right ventricle in patient with cardiac tamponade {{#ev:youtube|dwJkJr00v5c}}
