Donate Help Contact The AHA Sign In Home
American Heart Association
Circulation
Search: search_blue_button Advanced Search
Circulation. 1974;50:239-247

This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by HOROWITZ, M. S.
Right arrow Articles by POPP, R. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by HOROWITZ, M. S.
Right arrow Articles by POPP, R. L.

(Circulation. 1974;50:239.)
© 1974 American Heart Association, Inc.


Sensitivity and Specificity of Echocardiographic Diagnosis of Pericardial Effusion

MICHAEL S. HOROWITZ M.D.1; CLIFFORD S. SCHULTZ M.D.1; EDWARD B. STINSON M.D.1; DONALD C. HARRISON M.D.1; RICHARD L. POPP M.D.1

1 From the Divisions of Cardiology and Cardiovascular Surgery, Stanford University School of Medicine, Stanford, California.

In order to evaluate the reliability and sensitivity of echocardiograms for detecting and quantitating pericardial effusion, 41 patients had echocardiograms on the day prior to cardiac operation. A fluid trap was used to aspirate the pericardium at operation. Thirty-nine of 41 patients had echocardiograms of diagnostic quality. In 25 patients, the echocardiogram was negative for pericardial effusion, with 0-16 ml identified at operation. In 13 patients, the echocardiogram was positive for pericardial effusion, with 15-775 ml aspirated at operation. A transition of patterns of relative posterior epicardial-pericardial movement was noted as the pericardial fluid volume increased. More than 15 ml was always found when a posterior echo-free space persisted throughout the cardiac cycle between a flat pericardium relative to the epicardium. In the presence of such a posterior echo-free space, a large anterior echo-free space made a moderately large pericardial effusion likely. In the absence of this diagnostic posterior echo-free space, an anterior echo-free space had no diagnostic significance, as it was found in 11 patients with less than 16 ml of pericardial effusion. A small posterior echo-free space persisting throughout the cardiac cycle between pericardial and epicardial echoes demonstrating virtually identical movements was found in two patients without any surgical evidence for pericardial effusion, but with evidence of adhesive fibrocalcific pericardial disease. A method of estimating pericardial volume is proposed, which uses the difference between the cubed diameters at the end-diastole of the pericardium and epicardium.


Key Words: Ultrasound • Echo-free space

Submitted on December 3, 1973
Accepted on April 8, 1974




This article has been cited by other articles:


Home page
Journal of the American Animal Hospital AssociationHome page
A. A. Little, M. Steffey, and M. S. Kraus
Marked Pleural Effusion Causing Right Atrial Collapse Simulating Cardiac Tamponade in a Dog
J. Am. Anim. Hosp. Assoc., May 1, 2007; 43(3): 157 - 162.
[Abstract] [Full Text] [PDF]


Home page
Eur J EchocardiogrHome page
A. Mager, Y. Birnbaum, Y. Adler, S. Imbar, B. Strasberg, and A. Battler
The anteroposterior pericardial sac diameter measured by echocardiography correlates with the volume of pericardial effusion and with effort dyspnea
Eur J Echocardiogr, October 1, 2005; 6(5): 358 - 362.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
T. Sugiura, S. Nakamura, Y. Kudo, T. Okumiya, F. Yamasaki, and T. Iwasaka
Clinical Factors Associated With Persistent Pericardial Effusion After Successful Primary Coronary Angioplasty
Chest, August 1, 2005; 128(2): 798 - 803.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
Task Force members, B. Maisch, P. M. Seferovic, A. D. Ristic, R. Erbel, R. Rienmuller, Y. Adler, W. Z. Tomkowski, G. Thiene, M. H. Yacoub, et al.
Guidelines on the Diagnosis and Management of Pericardial Diseases Executive Summary: The Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology
Eur. Heart J., April 1, 2004; 25(7): 587 - 610.
[Full Text] [PDF]


Home page
ChestHome page
Y. Kudo, F. Yamasaki, T. Doi, Y. Doi, and T. Sugiura
Clinical Significance of Low Voltage in Asymptomatic Patients With Pericardial Effusion Free of Heart Disease
Chest, December 1, 2003; 124(6): 2064 - 2067.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
Y. Kudo, F. Yamasaki, Y. Doi, and T. Sugiura
clinical correlates of pr-segment depression in asymptomatic patients with pericardial effusion
J. Am. Coll. Cardiol., June 19, 2002; 39(12): 2000 - 2004.
[Abstract] [Full Text] [PDF]


Home page
ChestHome page
K. Hatada, T. Sugiura, H. Kamihata, S. Nakamura, N. Takahashi, F. Yuasa, and T. Iwasaka
Clinical Significance of Coronary Flow to the Infarct Zone Before Successful Primary Percutaneous Transluminal Coronary Angioplasty in Acute Myocardial Infarction
Chest, December 1, 2001; 120(6): 1959 - 1963.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. Hamada, T. Nishiue, S. Nakamura, T. Sugiura, H. Kamihata, H. Miyoshi, Y. Imuro, and T. Iwasaka
TIMI frame count immediately after primary coronary angioplasty as a predictor of functional recovery in patients with TIMI 3 reperfused acute myocardial infarction
J. Am. Coll. Cardiol., September 1, 2001; 38(3): 666 - 671.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
C. Bruch, A. Schmermund, N. Dagres, T. Bartel, G. Caspari, S. Sack, and R. Erbel
Changes in QRS voltage in cardiac tamponade and pericardial effusion: reversibility after pericardiocentesis and after anti-inflammatory drug treatment
J. Am. Coll. Cardiol., July 1, 2001; 38(1): 219 - 226.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
H. Kataoka and S. Takada
The role of thoracic ultrasonography for evaluation of patients with decompensated chronic heart failure
J. Am. Coll. Cardiol., May 1, 2000; 35(6): 1638 - 1646.
[Abstract] [Full Text] [PDF]


Home page
J. Thorac. Cardiovasc. Surg.Home page
F. I. Hsu, D. Keefe, D. Desiderio, and R. J. Downey
Echocardiographic and surgical correlation of pericardial effusions in patients with malignant disease
J. Thorac. Cardiovasc. Surg., May 1, 1998; 115(5): 1215 - 1216.
[Full Text] [PDF]


Home page
ANGIOLOGYHome page
R. Prakash, J. King, and W. S. Aronow
Enlarged Left Atrium Causing Possible False Positive Echocardiographic Diagnosis of Pericardial Effusion
Angiology, April 1, 1976; 27(4): 219 - 222.
[PDF]