Cas du 26/03/2015 : Pericardial Effusion

Presentation: A patient came to the OR with this echo loop.  The loop shows a pericardial effusion.

#1: What is the severity of the pericardial effusion?

#2: Please discuss how pericardial effusions are placed into the small, medium, or large category?

Explanation: This effusion is a small pericardial effusion.  Pericardial effusions are classified as small, medium, or large and are < 100ml, 100-500ml, or > 500ml respectively.  Since we can't easily measure the volume by echocardiography, small pericardial effusions are typically behind the inferolateral wall (posteriorly) of the heart.  As the effusion enlarges, it fills up the lateral and apical areas.  A large effusion is global and surrounds the heart.  Typically, large effusions will be global and the epicardial to pericardial distance will be more than 1 cm.