Diagnosis of pericardial abnormalities by 2D-echo: A pathology-echocardiography correlation in 85 patients

Initial echocardiographic characteristics of pericardial effusion determine the pericardial complications

“…Fibrinoid change of pericardium associated with pericardial inflammation, malignant cell seeding, or hypersensitivity reaction to the foreign protein have been regarded as causes of those echogenic materials [2]. In a previous pathology study, it was demonstrated that those echogenic substances identified on the echocardiography were acute fibrinous strands, malignancies, or chronic fibrous connective tissue [6]. The irregular cauliflower-like masses protruding from the pericardium and the epicardium into the PE space was surgically proven to be pericardial malignant metastases [5].…”

“…Group A consisted of patients with echo-free PE without any echogenic materials in PE (Fig. 1A) [6], while Group B consisted of patients with echogenic PE, including diffuse echogenic PE (Fig. 1B), intrapericardial septating fibrinous strands (Fig.…”

“…1C), and exudative frond-like coating (Fig. 1D) [2,3,6]. PE was classified into diffuse echogenic PE when whole PE was echogenic.…”

“…Those echogenic materials are regarded as consequences of pericardial inflammation, and observed in tuberculous, malignant and bacterial PE [2,3,5]. Those echogenic substances identified on the echocardiography were reported to be acute fibrinous strands, malignancies, or chronic fibrous connective tissue [6]. However, clinical implications of echogenic materials in PE have not been yet demonstrated.…”

Is autopsy dead in the ICU?

“…A diagnosis of fungal pneumonia was missed by open lung biopsy in a third patient [11]. In general, we continue to need the autopsy to determine the specificity of techniques such as echocardiography, even when it is used in conditions that are apparently easy to diagnose, such as those affecting the pericardium [12]. The same applies to the diagnosis of acute myocardial infarction by electrocardiography [13].…”