Intrapericardial Doppler Flow Signals in a Patient with Postsurgical Pericardial Effusion

Abstract

A 62-year-old female patient was admitted to our hospital because of a relapse of pericardial effusion complicating a recent aortic root replacement. At admission to our hospital, echocardiogram showed the reappearance of pericardial effusion and the presence of intrapericardial clots. Color Doppler and Pulsed-wave examinations showed a localized systolic flow within the pericardial space. Contrast enhanced computed tomography excluded abnormal communications with the cardiac chambers or with the aorta. The possible causes of this unusual Doppler finding are discussed.

Keywords: Pericardial effusion.

Figure 1

Echocardiogram from long-axis transducer position (modified) showing circumferential pericardial effusion with evidence of intra-pericardial fibrin clot adjacent to the proximal segment of the posterolateral lateral wall of the left ventricle (arrow). LV = Left ventricle.

Figure 2

Echo Color Doppler from four-chamber position showing intra-pericardial signal and fibrin clot adjacent to the proximal segment of the lateral wall of the left ventricle (arrow). LV = Left ventricle.

Figure 3

Echo Color Doppler from four-chamber position (modified) magnifying intra-pericardial color signal adjacent to the proximal segment of the lateral wall of the left ventricle.

Figure 4

Pulsed-Wave Doppler of the intrapericardial flow. Systolic flow velocity is 0.8 m/s, and direction is toward the ventricular apex.