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Published on: January 14, 2014
Blood or Fat? Differentiating Hemopericardium versus Epicardial Fat Using Focused Cardiac Ultrasound
Yuriy S Bronshteyn1,2, Nazish Hashmi1, Jamie R Privratsky1
1Duke University Health System, Duke University School of Medicine, Durham, NC 27710, USA.
Insights
Focused Cardiac Ultrasound (FoCUS) helps identify hypotension causes. This guide differentiates hemopericardium from epicardial fat using ultrasound images, crucial for accurate diagnosis at the bedside.
Area of Science:
- Emergency Medicine
- Cardiology
- Medical Imaging
Background:
- Point-of-care ultrasound, specifically Focused Cardiac Ultrasound (FoCUS), is vital for diagnosing hypotension.
- Distinguishing between hemopericardium and epicardial fat is critical for patient management.
- Hemopericardium, a cause of hypotension, can be mistaken for common epicardial fat.
Purpose of the Study:
- To provide guidance on differentiating hemopericardium from epicardial fat using FoCUS.
- To enhance the diagnostic accuracy of FoCUS users in identifying critical cardiac conditions.
Main Methods:
- Review of illustrative ultrasound images comparing epicardial fat and hemopericardium.
- Focus on visual characteristics to differentiate the two conditions.
Main Results:
- Key imaging features distinguishing hemopericardium from epicardial fat are presented.
- Guidance is provided for FoCUS users to improve recognition of these entities.
Conclusions:
- FoCUS is a valuable tool for assessing hypotension, but accurate differentiation of findings is essential.
- This review aims to improve the ability of clinicians to distinguish hemopericardium from epicardial fat via FoCUS.
Abstract:
Basic point-of-care ultrasound of the heart-also known as Focused Cardiac Ultrasound (FoCUS)-has emerged as a powerful bedside tool to narrow the differential diagnosis of causes of hypotension. The list of causes of hypotension that a FoCUS provider is expected to be able to recognize includes a compressive pericardial effusion due to hemopericardium (blood in the pericardial sac). But hemopericardium can be difficult to distinguish from a more common condition that is not immediately life-threatening: epicardial fat. This paper reviews illustrative images of both epicardial fat and hemopericardium to provide practice guidance to the FoCUS user on how to differentiate these two phenomena.
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