What are the possible false-positive echocardiographic findings 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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False-positive echocardiographic findings can occur in the presence of pleural effusions, pericardial thickening, increased epicardial fat tissue, atelectasis, and mediastinal lesions. Pericardial cysts, which are usually benign, can be seen classically in the right cardiophrenic angle and can be confused with pericardial effusion.

Epicardial fat tissue is more prominent anteriorly but may appear circumferentially, thus mimicking effusion. Fat is slightly echogenic and tends to move in concert with the heart, 2 characteristics that help to distinguish it from an effusion, which is generally echolucent and motionless. [18, 22, 23]

In patients with pericardial effusion, imaging from low to midposterior thorax can provide additional diagnostic echocardiographic images and should be used in patients in whom conventional images are technically difficult or require additional information.

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