Echocardiography identified three patients with a mitral anular mass. Fluoroscopy demonstrated a faint, homogeneous intracardiac calcific density in each patient. Cardiac catheterization and angiography were performed and showed no left ventricular inflow or outflow obstruction. One patient died suddenly and two patients had cardiac surgery (one for mitral regurgitation and another for constrictive pericarditis). Examination demonstrated that each mass was nonencapsulated, sterile and acellular and contained cholesterol, calcium and fatty acids. The clinical significance and cause of these masses are unclear at present.

Nine patients with clinical and hemodynamic evidence of cardiac tamponade underwent M-mode and two-dimensional echocardiography. Pericardial effusion was documented in each patient. Four patients demonstrated respiratory variation in ventricular volumes in association with paradoxical pulse. Right ventricular compression was present in seven. In five patients, echocardiography demonstrated diastolic left atrial compression. In all nine patients, the apical four chamber view revealed diastolic right atrial compression. Drainage of 450 to 1,800 cc of pericardial fluid relieved the cardiac tamponade and eliminated the echocardiographic findings associated with this disorder. These observations suggest that the echocardiographic findings of atrial compression is a sensitive sign of cardiac tamponade.

The three-dimensional echocardiographic reconstruction enabled visualization of the mitral valve so that commissural splitting and leaflet tears not seen on the two-dimensional echocardiogram became visible.