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Pericardial Diseases

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Abstract

The pericardium is a thin fibroelastic sac, comprised of both a serous visceral and fibrous parietal layer, which surrounds the heart and the great vessels. Echocardiography remains the initial imaging modality of choice and should be performed as a complete study or as a point of care when suspecting acute pericarditis. Presence of an abnormal septal motion from right to left in early diastole during inspiration, the presence of a plethoric IVC and dilated hepatic veins, and evidence of ventricular interdependence are the cornerstones of constrictive pericarditis physiology. Annulus paradoxus and annulus reversus are also strong indicators of constrictive pericarditis. The location, size, extent of the pericardial effusion and presence of loculations should be characterized using all four echocardiographic windows including PSLAX, PSAX, Apical, and the Subcostal views. Chamber collapse is an important indicator of the presence of tamponade physiology along with a septal bulge and peak mitral and tricuspid E-inflow velocity respiratory variation. Most cases of cardiac tamponade are treated with a pericardiocentesis.

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Abbreviations

2D:

Two dimensional

3D:

Three dimensional

ASA:

Aspirin

CMR:

Cardiac magnetic resonance

CP:

Constrictive pericarditis

CRP:

C-reactive protein

EF:

Ejection fraction

E:

Peak E-wave velocity of the mitral valve (cm/sec)

e′:

TDI of the mitral annulus

EKG:

Electrocardiogram

IVC:

Inferior vena cava

LA:

Left atrium

LV:

Left ventricular

LVEF:

Left ventricular ejection fraction

NSAID:

Non-steroidal anti-inflammatory drug

PSLAX:

Parasternal long axis

PSAX:

Parasternal short axis

RV:

Right ventricle

STE:

Speckle-tracking echocardiography

TDI:

Tissue Doppler imaging

TEE:

Transesophageal echocardiography

TTE:

Transthoracic echocardiography

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Authors and Affiliations

  1. The McGill University Health Centre, Montreal, Quebec, Canada

    Michael Chetrit MD, FRCPC & Vartan Mardigyan MD, FRCPC

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  1. Michael Chetrit MD, FRCPC
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  2. Vartan Mardigyan MD, FRCPC
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Correspondence to Vartan Mardigyan MD, FRCPC .

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Editors and Affiliations

  1. Rajaie Cardiovascular, Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran

    Anita Sadeghpour

  2. Rajaie Cardiovascular, Medical and Research Center, Echocardiography Research Center, Iran University of Medical Sciences, Tehran, Iran

    Azin Alizadehasl

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Chetrit, M., Mardigyan, V. (2018). Pericardial Diseases. In: Sadeghpour, A., Alizadehasl, A. (eds) Case-Based Textbook of Echocardiography. Springer, Cham. https://doi.org/10.1007/978-3-319-67691-3_20

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  • DOI: https://doi.org/10.1007/978-3-319-67691-3_20

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