Pericardial effusions are frequently seen in patients with critical illness and are often a key differential diagnosis in hemodynamic decompensation. Although identification of an anechoic space of a potential pericardial effusion can be performed with relative ease, a number of important steps are required to refute other false positives and determine its' significance. These three video tutorials will permit bedside sonographers to recognize potential false positives, evaluate the size and assess the hemodynamic significance, in conjunction with clinical examination.
Identification of a pericardial effusion
This video highlights key features that enable visual identification of a pericardial effusion and to distinguish from a pleural effusion. Pleural effusion is a key differential for any juxta-cardiac anechoic space.
This image to the left displays key differences between pericardial and pleural effusions on the PLAX view.
Does sizing matter?
This video tutorial will demonstrate gross assessment of pericardial effusion quantity. Importantly, size is not the key determinant of the hemodynamic significance of an effusion and other factors need to be considered (i.e rate of accumulation).
Is this pericardial effusion hemodynamically significant?
This tutorial will cover the salient 2D-echo features of a hemodynamically significant pericardial effusion. From diastolic collapse of the right ventricle to distension of the inferior vena cava, there are a number of 2D-echo indicators, which are an adjunct to your bedside assessment.