Which echocardiographic findings aid in the diagnosis 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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Echocardiography may identify features that suggest hemodynamically significant cardiac tamponade; however, this is a clincial (not echocardiographic) diagnosis. These findings include the following:

  • Collapse of the right atrium, especially if it lasts for a third of the cardiac cycle

  • Diastolic collapse of the right ventricle

  • In hypovolemic patients, the left atrium and left ventricle may also show signs of collapse

Rarely, the cause of the effusion can also be ascertained from echocardiography. The following echocardiographic findings may be helpful:

  • Presence of a coagulum in the pericardial space indicating a bloody pericardial effusion (aortic dissection, postoperative, or after other catheter-based procedures)

  • Presence of a pacemaker lead either in the vicinity or inside an area of localized effusion, indicating lead perforation as a cause

  • Presence of tumor (primary or secondary) in the pericardial space

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