How is pericardial effusion classified?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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M-mode echocardiography is adjunctive to two-dimensional (2-D) imaging for the detection of pericardial effusion. Effusions can be classified using M-mode according to the following system proposed by Horowitz et al [20] :

  • Type A - No effusion

  • Type B - Separation of epicardium and pericardium

  • Type C1 - Systolic and diastolic separation of pericardium

  • Type C2 - Systolic and diastolic separation of pericardium, attenuated pericardial motion

  • Type D - Pronounced separation of pericardium and epicardium with large echo-free space

In the parasternal long-axis and apical 4-chamber views, discordant changes in right and left ventricular cavity size can suggest pronounced interventricular dependence, also suggesting an echocardiographic “substrate” for tamponade. It is important to note that these changes occur independent of the cardiac cycle (as these are dependent on respiration).

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