What is the role of echocardiography in the diagnosis of cardiac tamponade?

Updated: Nov 28, 2018
  • Author: Chakri Yarlagadda, MD, FACC, FSCAI, FASNC, CCDS; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Prompt diagnosis is key to reducing the mortality risk for patients with cardiac tamponade. Although echocardiography provides useful information, cardiac tamponade is a clinical diagnosis. Echocardiography can be used to visualize ventricular and atrial compression abnormalities as blood cycles through the heart. The following may be observed with 2-dimensional (2-D) echocardiography:

  • An echo-free space posterior and anterior to the left ventricle and behind the left atrium

  • Early diastolic collapse of the right ventricular free wall

  • Late diastolic compression/collapse of the right atrium

  • Swinging of the heart in the pericardial sac

  • Left ventricular pseudohypertrophy

  • Inferior vena cava plethora with minimal or no collapse with inspiration

  • A greater than 40% relative inspiratory augmentation of blood flow across the tricuspid valve

  • A greater than 25% relative decrease in inspiratory flow across the mitral valve

See Workup for more detail.

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