ECHOCARDIOGRAPHY · PATHOLOGY

Pericardial effusion

Four Chamber · Apical fluid pocket

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Apical echocardiogram with a dark pericardial fluid pocket outside the heart apex

Hover over the fluid · Click to pin.

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Explore the anatomy

Chamber guides show visible regions. Valve pointers indicate their position, not individual leaflets.

UNDERSTAND THE FINDING

Fluid outside the heart

What is it?

A pericardial effusion is an abnormal collection of fluid in the sac surrounding the heart.

How to recognise it

Follow the dark fluid from the heart apex down the left outer border of the image. It lies outside the heart muscle. This case has fluid around the heart; the outline shows only the clearly visible portion, not its full extent.

Why does it look dark?

Fluid returns relatively few ultrasound echoes, so it often appears black. The important clue is its position outside the chambers—blood inside a normal chamber also looks dark.

REMEMBER

Effusion means fluid. Tamponade means the fluid is impairing heart filling. They are not interchangeable.

About this case & sources

This published patient developed acute pericardial effusion and tamponade after an inferior vena cava filter was removed. This recording was acquired before drainage. This lesson identifies fluid; the outline alone cannot establish tamponade or its severity.

Zhang, Wang & Liu (2021), Additional file 1, CC BY 4.0. A short apical four-chamber cine was cropped to remove peripheral identifiers and display text. The moving contour is an inset educational guide to the visible apical and image-left fluid, not a measured segmentation. Chamber contours are inset orientation guides to visible regions; the valve pointers indicate the atrioventricular junctions, not individual leaflet borders. Clinical review is pending.

Published case & original videos ↗CC BY 4.0 ↗Echo interpretation reference ↗ASE examination reference ↗Credits & image preparation ↗