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Pericardial effusion: Real and false.

Raut MS, Maheshwari A - Saudi J Anaesth (2015 Apr-Jun)

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac Anesthesiology, Sir Ganga Ram Hospital, New Delhi, India.

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Intraoperative transesophageal echocardiographic (TEE) transgastric view revealed large collection of fluid around the posterior aspect of heart giving picture of tamponade compressing heart [Figure 1 and Video Clip 1]... In images of above presented two cases, collection compressing heart is evident in the same transgastric short axis view... However, other TEE views in case 1 did not show pericardial effusion [Figure 3]... In transgastric view, falciform ligament is seen which indicates that the collection is of ascitic fluid [Figure 1]... Hence, this case depicts false appearance of pericardial effusion in presence of ascites... In case 2, other views also demonstrated pericardial effusion giving compression effect [Figure 4]... This was a case of true pericardial effusion with tamponade... Echocardiographically, such ascitic echo-free spaces can be mistaken for pericardial effusions and pericardial cysts, which can also present as echolucent spaces anterior to the right ventricle... The pericardium, diaphragm and parietal peritoneum separates the heart from ascitic fluid... On transthoracic echocardiography, falsiform ligament can be seen in the subdiaphragmatic view... Identification of falsiform ligament helps in the differential diagnosis of echofree space around the right heart border and the liver... Ascites is always recognized by visualizing falsiform ligament in this echolucent space... Transesophageal echocardiographic is definitely diagnostic in pericardial effusion, but comprehensive TEE examination will give proper diagnosis after ruling out other things.

No MeSH data available.


Transesophageal echocardiographic transgastric view showing collection around heart (marked by red arrow) yellow arrow showing falciform ligament of liver margin. RV: Right ventricle, LV: Left ventricle
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Figure 1: Transesophageal echocardiographic transgastric view showing collection around heart (marked by red arrow) yellow arrow showing falciform ligament of liver margin. RV: Right ventricle, LV: Left ventricle

Mentions: Case 1: A 18-year-old male patient with severe mitral stenosis, severe pulmonary hypertension, tricuspid regurgitation and right heart failure was scheduled for mitral valve replacement surgery. Intraoperative transesophageal echocardiographic (TEE) transgastric view revealed large collection of fluid around the posterior aspect of heart giving picture of tamponade compressing heart [Figure 1 and Video Clip 1].


Pericardial effusion: Real and false.

Raut MS, Maheshwari A - Saudi J Anaesth (2015 Apr-Jun)

Transesophageal echocardiographic transgastric view showing collection around heart (marked by red arrow) yellow arrow showing falciform ligament of liver margin. RV: Right ventricle, LV: Left ventricle
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4374243&req=5

Figure 1: Transesophageal echocardiographic transgastric view showing collection around heart (marked by red arrow) yellow arrow showing falciform ligament of liver margin. RV: Right ventricle, LV: Left ventricle
Mentions: Case 1: A 18-year-old male patient with severe mitral stenosis, severe pulmonary hypertension, tricuspid regurgitation and right heart failure was scheduled for mitral valve replacement surgery. Intraoperative transesophageal echocardiographic (TEE) transgastric view revealed large collection of fluid around the posterior aspect of heart giving picture of tamponade compressing heart [Figure 1 and Video Clip 1].

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiac Anesthesiology, Sir Ganga Ram Hospital, New Delhi, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Intraoperative transesophageal echocardiographic (TEE) transgastric view revealed large collection of fluid around the posterior aspect of heart giving picture of tamponade compressing heart [Figure 1 and Video Clip 1]... In images of above presented two cases, collection compressing heart is evident in the same transgastric short axis view... However, other TEE views in case 1 did not show pericardial effusion [Figure 3]... In transgastric view, falciform ligament is seen which indicates that the collection is of ascitic fluid [Figure 1]... Hence, this case depicts false appearance of pericardial effusion in presence of ascites... In case 2, other views also demonstrated pericardial effusion giving compression effect [Figure 4]... This was a case of true pericardial effusion with tamponade... Echocardiographically, such ascitic echo-free spaces can be mistaken for pericardial effusions and pericardial cysts, which can also present as echolucent spaces anterior to the right ventricle... The pericardium, diaphragm and parietal peritoneum separates the heart from ascitic fluid... On transthoracic echocardiography, falsiform ligament can be seen in the subdiaphragmatic view... Identification of falsiform ligament helps in the differential diagnosis of echofree space around the right heart border and the liver... Ascites is always recognized by visualizing falsiform ligament in this echolucent space... Transesophageal echocardiographic is definitely diagnostic in pericardial effusion, but comprehensive TEE examination will give proper diagnosis after ruling out other things.

No MeSH data available.