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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 midesophageal four chamber view showing pericardial collection around left side of heart. LA is huge with spontaneous echo contrast. Pr MV: Prosthetic mitral valve
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Figure 4: Transesophageal echocardiographic midesophageal four chamber view showing pericardial collection around left side of heart. LA is huge with spontaneous echo contrast. Pr MV: Prosthetic mitral valve

Mentions: 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. Effusion was drained by creating pleuropericardial window.


Pericardial effusion: Real and false.

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

Transesophageal echocardiographic midesophageal four chamber view showing pericardial collection around left side of heart. LA is huge with spontaneous echo contrast. Pr MV: Prosthetic mitral valve
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Transesophageal echocardiographic midesophageal four chamber view showing pericardial collection around left side of heart. LA is huge with spontaneous echo contrast. Pr MV: Prosthetic mitral valve
Mentions: 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. Effusion was drained by creating pleuropericardial window.

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.