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Clinical and hemodynamic correlation in patients with pericardial effusion and swinging heart by echocardiography
Insights
The "swinging heart" echocardiogram finding is a reliable indicator of cardiac tamponade. This sign, characterized by parallel ventricular wall motion, helps diagnose fluid accumulation around the heart.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- M-mode echocardiography is a key diagnostic tool in cardiology.
- Cardiac tamponade presents a significant clinical challenge requiring accurate diagnosis.
Purpose of the Study:
- To evaluate the diagnostic utility of the "swinging heart" phenomenon observed on M-mode echocardiography.
- To determine the association between the "swinging heart" pattern and cardiac tamponade.
Main Methods:
- Analysis of clinical and hemodynamic data from 13 patients with "swinging heart" on M-mode echocardiography.
- Review of right heart catheterization results and surgical findings in these patients.
- Comparison with patients diagnosed with cardiac tamponade but lacking the "swinging heart" sign.
Main Results:
- 10 of 13 patients with "swinging heart" showed the hemodynamic profile of cardiac tamponade.
- One additional patient exhibited cardiac compression during surgery.
- Cardiac tamponade was also diagnosed in patients without the "swinging heart" sign, often due to large pericardial clots.
Conclusions:
- The "swinging heart" pattern on M-mode echocardiography is a strong indicator of cardiac tamponade.
- This echocardiographic finding is generally reliable, with exceptions in cases of mechanical limitation by intrapericardial lesions.
Abstract:
The clinical and hemodynamic findings in 13 consecutive patients with "swinging heart" on M-mode echocardiography were analyzed. In these patients the anterior right ventricular and posterior left ventricular walls and interventricular septum moved almost parallel to each other throughout the cardiac cycle, often with exaggerated excursion. In 10 of 13 patients right heart catheterization revealed the hemodynamic profile of cardiac tamponade, while one additional patient was found to have evidence of cardiac compression at the time of surgery. In the remaining two patients no acute invasive diagnostic procedures were performed. During the same observation period cardiac tamponade was observed in five patients without echocardiographic evidence of a swinging heart, and four of these had large clots in the pericardial space. Thus, the swinging heart pattern appears to be a reliable marker of cardiac tamponade, except in those patients with intrapericardial lesions which mechanically limit cardiac motion.