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ARTICLE |

Echocardiographic Evaluation of Pericardial Disease FREE

P. Anthony Chandraratna, MD, MRCP
[+] Author Affiliations

This article is one of a series sponsored by the American Heart Association.

Reprint requests to School of Medicine, University of Southern California, 2025 Zonal Ave, Los Angeles, CA 90033 (Dr Chandraratna).


JAMA. 1983;250(19):2677-2680. doi:10.1001/jama.1983.03340190079040
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VARIOUS forms of pericardial disease are commonly encountered in clinical practice. Echocardiography is an effective noninvasive method of assessing many different cardiac conditions; this article explores the uses and limitations of echocardiography in evaluating pericardial disease, with a special emphasis on two-dimensional echocardiography.

Pericardial Effusion  One of the first applications of echocardiography was its use in diagnosing pericardial effusion.1 The appearance of an echo-free space posterior to the heart, with disappearance or marked reduction of the space at the junction of the left ventricle and left atrium, and absence of motion of the pericardium are the echocardiographic hallmarks of pericardial effusion. The volume of pericardial fluid can be roughly quantitated using M-mode echocardiography. A small, posterior echo-free space denotes a small pericardial effusion, and as the amount of pericardial fluid increases, the posterior space becomes larger. With a large pericardial effusion, a large posterior as well as an anterior

REFERENCES

Feigenbaum H, Waldhausen JA, Hyde LP:  Ultrasound diagnosis of pericardial effusion . JAMA 1965;;191:711-714.
Martin RP, Rakowski H, French J, et al:  Localization of pericardial effusion with wide angle phased array echocardiography . Am J Cardiol 1978;;42:904-912.
Chandraratna PAN, Aronow WS, Lurie M, et al:  Role of cross-sectional echocardiography in the evaluation of pericardial effusion . Compr Ther 1981;;7:46-51.
D'Cruz IA, Cohen HC, Prabhu R, et al:  Diagnosis of cardiac tamponade by echocardiography: Changes in mitral valve motion and ventricular dimensions, with special reference to paradoxical pulse . Circulation 1975;;52:460-465.
Armstrong WF, Helper DJ, Schilt BF, et al:  Diastolic collapse of the right ventricle: Echocardiographic evidence of occult cardiac tamponade , abstracted. Am J Cardiol 1982;;49:1010.
Gillam LD, Guyer D, King ME, et al:  Hydrodynamic compression of the right atrial free wall, a new highly-sensitive echocardiographic sign of cardiac tamponade , abstracted. Am J Cardiol 1982;;49:1010.
Chandraratna PAN, Aronow WS:  Echocardiographic observations on the limitations of surgical methods of pericardial drainage . JAMA 1979;;242:1062-1063.
Nanda NC, Gramiak R, Gross CM:  Echocardiography of cardiac valves in pericardial effusion . Circulation 1976;;54:500-504.
Chandraratna PAN, First J, Langevin E, et al:  Clinical usefulness of echocardiographic contrast studies during pericardiocentesis . Ann Intern Med 1977;;87:199-200.
Chandraratna PAN, First J, Imaizumi T:  Confirming needle position during pericardiocentesis—the echocardiogram versus the ECG . Cardiovasc Med 1978;;3:1074-1076.
Chandraratna PAN, Aronow WS, Imaizumi T:  Role of echocardiography in detecting the anatomic and physiologic abnormalities of constrictive pericarditis . Am J Med Sci 1982;;383:141-146.
Schnittger I, Bowden RE, Abrams J, et al:  Echocardiography: Pericardial thickening and constrictive pericarditis . Am J Cardiol 1978;; 42:388-395.
Chandraratna PAN, Imaizumi T:  Echocardiographic diagnosis of thickened pericardium . Cardiovasc Med 1978;;3:1279-1282.
Strunk BL, Fitzgerald JW, Lipton M, et al:  The posterior aortic wall echocardiogram: Its relationship to left atrial volume change . Circulation 1976;;54:744-750.
Chandraratna PAN, Aronow WS:  Detection of pericardial metastases by cross-sectional echocardiography . Circulation 1981;;63:197-199.

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Feigenbaum H, Waldhausen JA, Hyde LP:  Ultrasound diagnosis of pericardial effusion . JAMA 1965;;191:711-714.
Martin RP, Rakowski H, French J, et al:  Localization of pericardial effusion with wide angle phased array echocardiography . Am J Cardiol 1978;;42:904-912.
Chandraratna PAN, Aronow WS, Lurie M, et al:  Role of cross-sectional echocardiography in the evaluation of pericardial effusion . Compr Ther 1981;;7:46-51.
D'Cruz IA, Cohen HC, Prabhu R, et al:  Diagnosis of cardiac tamponade by echocardiography: Changes in mitral valve motion and ventricular dimensions, with special reference to paradoxical pulse . Circulation 1975;;52:460-465.
Armstrong WF, Helper DJ, Schilt BF, et al:  Diastolic collapse of the right ventricle: Echocardiographic evidence of occult cardiac tamponade , abstracted. Am J Cardiol 1982;;49:1010.
Gillam LD, Guyer D, King ME, et al:  Hydrodynamic compression of the right atrial free wall, a new highly-sensitive echocardiographic sign of cardiac tamponade , abstracted. Am J Cardiol 1982;;49:1010.
Chandraratna PAN, Aronow WS:  Echocardiographic observations on the limitations of surgical methods of pericardial drainage . JAMA 1979;;242:1062-1063.
Nanda NC, Gramiak R, Gross CM:  Echocardiography of cardiac valves in pericardial effusion . Circulation 1976;;54:500-504.
Chandraratna PAN, First J, Langevin E, et al:  Clinical usefulness of echocardiographic contrast studies during pericardiocentesis . Ann Intern Med 1977;;87:199-200.
Chandraratna PAN, First J, Imaizumi T:  Confirming needle position during pericardiocentesis—the echocardiogram versus the ECG . Cardiovasc Med 1978;;3:1074-1076.
Chandraratna PAN, Aronow WS, Imaizumi T:  Role of echocardiography in detecting the anatomic and physiologic abnormalities of constrictive pericarditis . Am J Med Sci 1982;;383:141-146.
Schnittger I, Bowden RE, Abrams J, et al:  Echocardiography: Pericardial thickening and constrictive pericarditis . Am J Cardiol 1978;; 42:388-395.
Chandraratna PAN, Imaizumi T:  Echocardiographic diagnosis of thickened pericardium . Cardiovasc Med 1978;;3:1279-1282.
Strunk BL, Fitzgerald JW, Lipton M, et al:  The posterior aortic wall echocardiogram: Its relationship to left atrial volume change . Circulation 1976;;54:744-750.
Chandraratna PAN, Aronow WS:  Detection of pericardial metastases by cross-sectional echocardiography . Circulation 1981;;63:197-199.
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