What is the role of Doppler 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

Transmitral and transtricuspid inflow velocities should be investigated to assess for respiratory variation. Decreases in flow during inspiration (transmitral >25%) or expiration (transtricuspid >40%) should raise the suspicion of clinically significant interventricular dependence and tamponade physiology. However, these findings may be less evident or, in fact, absent in patients on mechanical ventilation, even in the presence of a hemodynamically significant pericardial effusion. [21]

Pulmonic vein inflow may show a decrease in early diastolic flow with hemodynamically significant effusions. Plethoric inferior vena cava with less than 50% collapse during inspiration may indicate elevated right atrial pressures. Hepatic vein diastolic flow reversal seen during expiration is another classic manifestation of ventricular interdependence.


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