Large pericardial effusion

Images by Genevieve Carbonatto

PLAX view. Very large pericardial effusion. Heart “swinging” in fluid



Size should be measured at the end of diastole. To be accurate this should be done using the ECG for timing. Practically speaking the exact size of the effusion is not important. This effusion is circumferential and is over 2cm in depth around the heart. Whether there is tamponade or not  depends on how the patient presents clinically. Is there hypotension, tachycardia, shortness of breath?

This an M mode through the heart. The right ventricular wall is seen to collapse (there is a dip in the M mode in diastole)

4 chamber view :Large effusion, RV free wall collapse in diastole

Subcostal view

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