Contemporary echocardiographic assessment of pericardial effusion and cardiac tamponade

Abstract

The aim: the aim of this review is to address the challenges in echocardiographic diagnosis of pericardial effusion, which can potentially lead to a lifethreatening condition called cardiac tamponade. This article discusses the possibilities and prognostic value of transthoracic echocardiography in the diagnosis of pericardial effusion and cardiac tamponade.Materials and Methods. An analysis of Russian and foreign literature was conducted using eLibrary and PubMed databases. The following keywords were used: «pericardial effusion», «cardiac tamponade», «constrictive pericarditis», «pericarditis», «pericarditis in echocardiography», «перикардиальный выпот», «перикардит», «тампонада сердца», «диагностика перикардита». The included scientific papers and articles were published from 2013 to 2023. The research method used in the analysis was descriptive-analytical.Results. Pericardial effusion is the accumulation of fluid in the pericardial cavity, which can lead to cardiac tamponade, disrupting normal hemodynamics and cardiac chamber filling, ultimately resulting in systemic hypotension and cardiac arrest. Therefore, it is a life-threatening condition that requires immediate verification, primarily through echocardiography, followed by the determination of treatment strategy. A structured approach, including 2D mode, M-mode, and Doppler echocardiographic assessment, evaluating the quantity and quality of pericardial fluid, cardiac chamber collapse, diastolic ventricular size variability with the respiratory cycle, paradoxical interventricular septum motion, inferior vena cava collapse, respiratory flow variation through valves, and blood flow in hepatic and pulmonary veins, should provide the treating physician with the necessary information for choosing the treatment method. This article discusses key echocardiographic features that will ensure the appropriate assessment of patients with pericardial effusion and/or cardiac tamponade. Among all the mentioned features, the absence of cardiac chamber collapse is likely to have the highest negative prognostic value for excluding cardiac tamponade.