False-negative findings in pericardial effusion using M-mode echocardiography

Windle, John R.; Felix, Gary L.; Pinsky, William W.

doi:10.1007/bf02242260

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Accelerated atherosclerosis may cause ischemic heart disease in patients undergoing mainte nance hemodialysis, especially those with sustained hy pertension prior to initiation of dialysis [3,4,20], Pericarditis in patients receiving hemodialysis can be multifactorial and is often asymptomatic. The presence of pericardial effusion can be missed by M-mode echo cardiography [21,22], especially when most of the fluid is adjacent to the right atrium. Two-dimensional echo cardiography is superior for the detection of pericardial effusion, which was found in 54% of our patients, but high aortic valve gradients.…”

Section: Relation Between Auscultatory and Doppler Echocardiographie mentioning

confidence: 99%

Echocardiographic and Doppler Findings in Patients with Chronic Renal Failure on Hemodialysis

Meissner¹,

Panidis²,

McAllister³

et al. 1990

Am J Noninvas Cardiol

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Two-dimensional and Doppler echocardiography were performed in 48 patients (31 men) aged 55 ± 17 years with chronic renal failure (CRF) on hemodialysis for a mean of 3.9 years. Systemic hypertension was present in 44 patients, and a systolic and diastolic murmur in 42 and 6 patients, respectively. Serum creatinine was 10.6 ± 3.1 mg/dl, BUN 69 ± 28 mg/dl and hemoglobin 9 ± 2 g/dl. Left ventricular (LV) hypertrophy was seen in 22 (46%) patients, LV dilatation in 24 (50%) and systolic LV dysfunction in 25 (52%) patients. Pericardial effusion, usually small, was detected in 26 (54%) patients. Peak forward flow velocities (m/s) across each valve by Doppler were: 1.6 ± 0.7 (aortic), 1.0 ± 0.3 (mitral), 0.6 ± 0.2 (tricuspid), and 1.1 ±0.3 (pulmonic). Only 2 patients had significant aortic stenosis (peak velocity ≥ 4.0 m/s). Peak velocities had no correlation with patients’ age, heart rate, duration of hemodialysis, creatinine, or BUN. Aortic regurgitation was detected in 21 (45%) patients, mitral in 38 (79%), tricuspid in 28 (58%) and pulmonary regurgitation 15 (35%) patients. Mitral regurgitation was more common in patients with mitral annular calcification and those with LV dysfunction. Regurgitation was usually mild but multiple valve regurgitation was seen in 31/48 (65 %) patients, involved 3 valves in 13 and all 4 valves in 8 patients. Thus, patients with CRF on hemodialysis have: (1) a high incidence of LV dysfunction, mitral annular calcification and pericardial effusion, (2) increased aortic valve flow velocities but rarely stenosis, and (3) multi valvular regurgitation, more commonly mitral and tricuspid, and usually mild.

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Section: Relation Between Auscultatory and Doppler Echocardiographie mentioning

confidence: 99%

Echocardiographic and Doppler Findings in Patients with Chronic Renal Failure on Hemodialysis

Meissner¹,

Panidis²,

McAllister³

et al. 1990

Am J Noninvas Cardiol

View full text Add to dashboard Cite

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Illustrative cases in pericardial effusion misdetection: Correlation of echocardiography and CT

Yousem

Traill

Wheeler

et al. 1987

Cardiovasc Intervent Radiol

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Eight equivocal two-dimensional echocardiograms with concurrent CT scans were evaluated to identify potential pitfalls in pericardial effusion detection. By echocardiography, two pleural effusions were felt to be pericardial, two hemopericardiums were interpreted as normal myocardium, three loculated pericardial effusions were not seen or were misinterpreted as other mediastinal collections, and one epicardial lipoma was called a pericardial effusion. When the clinical suspicion for pericardial effusion does not correlate with echocardiographic findings, CT scanning may be the definitive arbiter of pericardial disease.

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False-negative findings in pericardial effusion using M-mode echocardiography

Cited by 2 publications

References 11 publications

Echocardiographic and Doppler Findings in Patients with Chronic Renal Failure on Hemodialysis

Echocardiographic and Doppler Findings in Patients with Chronic Renal Failure on Hemodialysis

Illustrative cases in pericardial effusion misdetection: Correlation of echocardiography and CT

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