What is the role of echocardiography in the workup of pericardial effusion?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Echocardiography is the imaging modality of choice for the diagnosis of pericardial effusion, as the test can be performed rapidly and in unstable patients. Most importantly, the contribution of pericardial effusion to overall cardiac enlargement and the relative roles of tamponade and myocardial dysfunction in altered hemodynamics can be evaluated with echocardiography. (See the images below.) [18]

Echocardiogram (parasternal, long axis) of a patie Echocardiogram (parasternal, long axis) of a patient with a moderate pericardial effusion.
Subcostal view of an echocardiogram that shows a m Subcostal view of an echocardiogram that shows a moderate to large amount of pericardial effusion.
This echocardiogram shows a large amount of perica This echocardiogram shows a large amount of pericardial effusion (identified by the white arrows).

Patients with viral cardiomyopathy, especially in the acute setting, may have a similar presentation to patients with pericardial effusion, with an enlarged heart being seen on chest radiographs. Echocardiography readily distinguishes the difference between enlarged cardiac chambers and a pericardial effusion.


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