Echocardiographic Evaluation of Pericardial Disease

VARIOUS forms of pericardial disease are commonly encountered in clinical practice. Echocardiography is an effective noninvasive method of assessing many different cardiac conditions; this article explores the uses and limitations of echocardiography in evaluating pericardial disease, with a special emphasis on two-dimensional echocardiography. Pericardial Effusion One of the first applications of echocardiography was its use in diagnosing pericardial effusion.1The appearance of an echo-free space posterior to the heart, with disappearance or marked reduction of the space at the junction of the left ventricle and left atrium, and absence of motion of the pericardium are the echocardiographic hallmarks of pericardial effusion. The volume of pericardial fluid can be roughly quantitated using M-mode echocardiography. A small, posterior echo-free space denotes a small pericardial effusion, and as the amount of pericardial fluid increases, the posterior space becomes larger. With a large pericardial effusion, a large posterior as well as an anterior