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Echocardiography 5 minutes before starting  

Examples of pathological findings

—Echocardiographic examinations

—Cardiac function and PA pressure

—Examples of pathological

Valvular heart disease
Intracardiac masses
Pericardial disease
Aortic dissection
Congenital heart disease

Pericardial disease

Constrictive pericarditis

Pericardial effusion

Pericardial effusion estimation is usually done cualitatively. Measurements of systolic and diastolic dimensions from parasternal in M-mode is important, in order to allow follow-up controls. Hemodynamic severity can be assessed through evidence of atrial or ventricular wall compression, interventricular septum displacement during inspiration and inferior vena cava plethora with blunted respiratory response.

Left: small pericardial effusion with inferior basal localization.

Right: small pericardial effusion with posterior basal localization.

Left: circular, mid-size pericar- dial effusion, with posterior und lateral accentuation.

Right: mid-size pericardial effu- sion, as well as large pleural effusion clear delimitated through parietal pericardial line.

Left: mid-size to large pericardial effusion with severe hemodynamic compromise, as evidenced through RV compression.

Right: large, circular pericardial effusion. RV and LV filling show respiratory dependent compro- mise.

Left: this same case from the parasternal short axis. Aspirated volumen was 1.5 liters.

Right: inferior vena cava is plethoric and without respiratory collapse, a sign of hemodynamic severity.


Constrictive pericarditis

Following images show charac- teristics of pericardial compres- sion.

Left: contraction of the free RV wall is impeded through the organized pericardial effusion. RV expands during filling at the beginning of each inspiration, only through a septal shift toward the LV (septal bounce).

Right: E-wave shows a clear (> 25 %) increase in inspiration (1).

Left: tricuspid regurgitation is also more evident during inspiration, here more accentuated as in physiologic status.

Right: tricuspid regurgitation maximal velocity becomes lower as EROA increases.

Left: inferior vena cava is plethoric and show no inspiratory collapse.

Right: antegrade velocities in suprahepatic vein also show clear respiratory accentuacion.