Pericardial effusion: Diagnostic value of the subcostal acoustic window (inferior vena cava‐right atrial projection)

Abstract

Summary: To validate the usefulness of the subcostal acoustic window (inferior vena cava-right atrial projection) for the echocardiographic diagnosis of pericardial effusion we studied 40 patients with pericardial effusion detected through the parasternal approach. A group of 100 patients without evidence of effusion constitutes the control group. In all patients in the control group, acontact betweenthe right atrial wall andthediaphragm wasnotedduring the cardiac cycle (specificity: 100%). This had also been detected in 15 of 18 patients with mild effusion and in only 1 of 1 1 patients with moderate effusion, and in none of 1 1 patients with severe effusion (overall sensitivity: 60%). Therefore, moderate and severe pericardial effusions can bedetectedinmostcases(95.4%) below the right atrial wall through the subcostal inferiorvenacava-right atrialprojection. The echocardiographic criteria for its diagnosis is the lackof contact through the cardiac cycle between right atrial wall and the diaphragm.