case2- answer

[pbruss]

electrical alternans is was i saw. that with the relative enlargment of the cardiac silouette on the CXR were concerning for pericardial effusion. i attached an egk tracing the EA and the CXRs with the diameter of the heart in red. a bedside US did show a periicardial effusion. she got addmittied and consult to cards.

what finding on bedside US indicated that she did not need an emergent pericardialcentsis?

Attachments:

[Bjs04f]

Lack of septal wall intrusion into LV durin diastole. With normal filling and normal vitals a pericardiocentesis isnt needed.

[pbruss]

Collapse of Right ventricle during diastole is what you are looking for. Check out video from YouTube. Remember it's not the volume but the time it took to accumulate. In the acute setting as little as 15-20 cc's can cause tampomade.

www.youtube.com/watch?v=QjqrO71mg0k&sns=em

[pbruss]

Try this link if first one doesn't work


youtu.be/QjqrO71mg0k