Circulation. 1999;100:e47
(Circulation. 1999;100:e47.)
© 1999 American Heart Association, Inc.
Circulation Electronic Pages |
Pleural Effusion on Transthoracic Echocardiogram
Linda B. Pauliks, MD
From the Division of Pediatric Cardiology, Cornell University Medical
Center, New York, NY.
Correspondence to Linda B. Pauliks, MD, Division of Pediatric Cardiology, Cornell University Medical Center, 525 E 68th St, New York, NY 10021. E-mail lbpauliks{at}aol.com
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Introduction
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 Top
 Introduction
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A4-year-old girl
with tetralogy of Fallot had complete repair
by open-heart surgery with
patch closure of the ventricular
septal defect, resection
of the pulmonary valve, and placement
of a transannular
pericardial patch to enlarge the right ventricular
outflow
tract. On the day of discharge, a 2D echocardiogram
revealed a small
anterior pericardial effusion and a large pleural
effusion, seen here
by transthoracic echocardiogram (Figure
1
) from a rotated parasternal long-axis
view. Figure 2
shows
a schematic of the
echocardiogram. An atelectatic segment of
the lung behind the right
atrium looked like the uninflated
lung of the fetus and permitted
transmission of the ultrasound
beam that is usually reflected by
air-filled spaces. The white
structure at the bottom of the frame
represents the posterior
chest wall. At the age of 4 years and
8 months, the patient
weighed only 14.4 kg (third percentile for
age). Note also the
right ventricular
hypertrophy and enlargement.
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Figure 1. Rotated parasternal long-axis view demonstrates
hypertrophied and enlarged right ventricle, dilated right atrium, an
atelectatic segment of lung, and a large posterior pleural effusion and
posterior chest wall in a 4-year-old patient after repair of tetralogy
of Fallot.
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Figure 2. Schematic of Figure 1 . RV indicates right
ventricle; RA, dilated right atrium; L, lung; PE, posterior pleural
effusion; and CW, posterior chest wall.
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Footnotes
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The editor of Images in Cardiovascular Medicine is Hugh A. McAllister,
Jr, MD, Chief, Department of Pathology, St Luke's Episcopal
Hospital and Texas Heart Institute, and Clinical Professor of
Pathology, University of Texas Medical School and Baylor College
of Medicine.
Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.
