M-Mode and Two-Dimensional Echocardiography in Congenital Absence of the Pericardium

Magnetic Resonance Imaging Differentiated Partial From Complete Absence of the Left Pericardium in a Case of Leftward Displacement of the Heart

“…[2][3][4][5]11,14 Similarly, echocardiographic features reflecting the leftward displacement of the heart, as in this case, have been described. [6][7][8] These features disappeared in the right lateral position because of the right-sided pericardial support. However, almost all previous reports describe leftward displacement of the heart as being characteristic only in complete absence of the left pericardium.…”

“…[6][7][8] The RV dilatation in M-mode echocardiogram has been described an untrue sign caused by lateral rotation of the heart, 6 and that 2-dimensional echocardiography reveals the normal size of the RV. 7 However, Beppu et al confirmed that the biventricular volumes are really increased in the left lateral position using calculations from computed tomography. 16 They speculated that there are not only changes in the cardiac position but also hemodynamic changes with postural alterations in this entity.…”

“…It was considered that these 2 characteristic M-mode echocardiographic findings with postural alterations were related to the deeper position and excessive anterior movement during systole of the whole heart in the left lateral position. 7,8 Furthermore, the periods of systolic motion of the LV posterior wall and LV early filling appeared to be prolonged in the right lateral position. Biventricular dimensions were increased when his posture was altered from the right to the left lateral position, whereas they remained within normal values (LV end-diastolic internal dimension increased from 41 mm in the right to 48 mm in the left lateral position; right ventricular (RV) end-diastolic internal dimension from 16 mm to 24 mm, respectively).…”

“…1 The features of complete absence of the left pericardium on chest X-ray and echocardiography, which are mainly related to the displacement of the whole heart, have been described by many investigators. [2][3][4][5][6][7][8] In partial absence of the pericardium, the characteristic features are quite different from those of complete absence of the pericardium because partial absence is occasionally complicated with herniation of a cardiac structure. [9][10][11] We present a case of partial absence of the left pericardium that was diagnosed by delineating the pericardium with magnetic resonance imaging (MRI), although the chest X-ray and echocardiographic features indicated a complete absence.…”

Congenital Absence of the Left Pericardium: Nuclear Magnetic Resonance and Other Imaging Techniques

“…Most reports mentioned échocardiographie features similar to right ventricular volume overload, suggesting they are caused by a clockwise rotation along the longitu dinal axis and leftward shift of the heart due to lack of pericardium [8,9]; however, localized abnormality of the left ventricular contour or isolated expansion of the left atrial appendage have also been described [33-35] and more recent cardiac doppler analysis has offered addi tional information in the evaluation of various differ ential diagnoses; like 2D-echo, angiocardiography per mits only a differential diagnosis, since it fails to identify the pericardium [26][27][28][29][30][31], and may lead to an incorrect diagnosis [35].…”