Chapter 12 - Echocardiographic Diagnosis of Cardiac Tamponade


Video 12-1. Parasternal long-axis view. Spatial relationship between pleural, pericardial effusions, and descending aorta. Pericardial effusion lies anterior to and pleural fluid is posterior to the descending aorta in supine position.
Video 12-2. Apical four-chamber view. Large pericardial effusion present. Right atrial collapse during diastole.
Video 12-3. Subxiphoid view. Large pericardial effusion present. Right ventricle is completely collapsed during early diastole, sign that is very specific for cardiac tamponade. RV, right ventricle; LV, left ventricle; LA, left atrium; RA, right atrium; PF, pericardial effusion.
Video 12-4. Apical four-chamber view. Large pericardial effusion, “swinging heart.”
Video 12-5. Long parasternal view. Large pericardial effusion. Right ventricle is nearly collapsing during diastole.
Video 12-6. Plethora of the inferior vena cava (IVC). IVC is enlarged and doesn’t show respirophasic changes. IVC plethora is an indicator of elevated right atrial pressure.
Video 12-7. Ultrasound-guided pericardiocentesis using a subxiphoid approach. After obtaining an adequate subcostal window, needle is inserted between the xiphoid process and the left costal margin. Using real-time echocardiography, the needle is advanced and visualized as it enters the pericardial sac. (Video courtesy of Dr. A. Levitov.)