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.
Submitted on December 3, 1973
© 1974 American Heart Association, Inc.
Sensitivity and Specificity of Echocardiographic Diagnosis of Pericardial Effusion
Key Words: Ultrasound • Echo-free space
Accepted on April 8, 1974
This article has been cited by other articles:
 |
|
 |
|
  T Sugiura, Y Kumon, H Kataoka, Y Matsumura, H Takeuchi, and Y. Doi Asymptomatic pericardial effusion in patients with systemic lupus erythematosus Lupus, February 1, 2009; 18(2): 128 - 132. [Abstract] [PDF]
|
|
|
|
 |
|
 R Som, A Li, R McIntosh, and G W Lloyd Acute dyspnoea, dysphagia, and non-specific chest pain in a smoker BMJ, December 29, 2008; 337(dec29_2): a2678 - a2678. [Full Text]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 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]
|
|
|
|
 |
|
 A. SHAH and E. VARIYAM Pericardial Effusion Associated With Ascites Secondary to Hepatic Cirrhosis Arch Intern Med, June 1, 1989; 149(6): 1462 - 1462. [Abstract] [PDF]
|
|
|
|
|
|
A. Shah and E. Variyam Pericardial Effusion and Left Ventricular Dysfunction Associated With Ascites Secondary to Hepatic Cirrhosis Arch Intern Med, March 1, 1988; 148(3): 585 - 588. [Abstract] [PDF]
|
|
|
|
|
|
E. P. Variyam and A. Shah Pericardial Effusion and Left Ventricular Function in Patients With Acute Alcoholic Pancreatitis Arch Intern Med, May 1, 1987; 147(5): 923 - 925. [Abstract] [PDF]
|
|
|
|
|
|
K. W. Ma, D. C. Brown, B. W. Steele, and A. H. L. From Serum Creatine Kinase MB Isoenzyme Activity in Long-term Hemodialysis Patients Arch Intern Med, February 1, 1981; 141(2): 164 - 166. [Abstract] [PDF]
|
|
|
|
 |
|
 R. L. POPP, D. S. RUBENSON, C. R. TUCKER, and J. W. FRENCH Echocardiography: M-Mode and Two-Dimensional Methods Ann Intern Med, December 1, 1980; 93(6): 844 - 856. [Abstract] [PDF]
|
|
|
|
|
|
W. R. Jacobs and J. V. Talano Cardiomegaly and Paradoxical Pulse Arch Intern Med, July 1, 1978; 138(7): 1125 - 1126. [Abstract] [PDF]
|
|
|
|
|
|
W. R. Jacobs, J. V. Talano, and H. S. Loeb Echocardiographic Interpretation of Pericardial Effusion Arch Intern Med, April 1, 1978; 138(4): 622 - 625. [Abstract] [PDF]
|
|
|
|
|
|
J. V. Talano, W. R. Jacobs, and L. Stephanides Symptoms of Palpitations and Dyspnea With an Abnormal Ventricular Echocardiogram Arch Intern Med, January 1, 1978; 138(1): 145 - 146. [Abstract] [PDF]
|
|
|
|
|
|
A. MILLMAN, J. MELLER, M. MOTRO, H. S. BLANK, I. HOROWITZ, M. V. HERMAN, and L. E. TEICHHOLZ Pericardial Tumor or Fibrosis Mimicking Pericardial Effusion by Echocardiography Ann Intern Med, April 1, 1977; 86(4): 434 - 436. [Abstract] [PDF]
|
|
|
|
 |
|
 A. L. Riba and J. Morganroth Unsuspected Substantial Pericardial Effusions Detected by Echocardiography JAMA, December 6, 1976; 236(23): 2623 - 2625. [Abstract] [PDF]
|
|
|
|
|
|
S. Zoneraich, O. Zoneraich, and J. J. Rhee New, Poorly Recognized Echocardiographic Findings: Occurrence in Patients With Pericardial Effusion JAMA, October 25, 1976; 236(17): 1954 - 1957. [Abstract] [PDF]
|
|
|
|
|
|
Cardiovascular Disease: An Annotated Bibliography of Recent Literature: References to Journal Articles and Other Papers Ann Intern Med, October 1, 1976; 85(4): 544 - 548. [Abstract] [PDF]
|
|
|
|
|
|
R. E. Kleiger Chest Pain in Patients Seen in Emergency Clinics JAMA, August 9, 1976; 236(6): 595 - 597. [Abstract] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
W. E. RADTKE, A. J. TAJIK, G. T. GAU, T. T. SCHATTENBERG, E. R. GIULIANI, and R. G. TANCREDI Atrial Septal Defect: Echocardiographic Observations: Studies in 120 Patients Ann Intern Med, March 1, 1976; 84(3): 246 - 253. [Abstract] [PDF]
|
|