title: A novel application of contrast echocardiography to exclude active coronary perforation bleeding in patients with pericardial effusion.
abstract: Management of hemodynamically significant cardiac tamponade will most often require pericardial drainage. In the absence of hemodynamic evidence of tamponade, however, management of a pericardial effusion represents a clinical dilemma. Pericardial leakage of blood may be transient, and extravasation may have stopped by time of echocardiographic assessment. Besides its usefulness in ischemic heart disease, contrast echocardiography might be applied in the context of coronary perforations. We report the use of contrast echocardiography in four cases of coronary perforation without overt signs of cardiac tamponade as a tool to streamline decision making as to whether perform pericardiocentesis or not. Our series demonstrate the clinical utility and effectiveness of echocardiographic contrast imaging to confirm or exclude active bleeding into the pericardial space when not otherwise visible by conventional imaging measures.
authors: Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.
authors: Rodrigo
authors: R
authors: Bagur
authors: Mathieu
authors: M
authors: Bernier
authors: David E
authors: DE
authors: Kandzari
authors: Dimitri
authors: D
authors: Karmpaliotis
authors: Nicholas J
authors: NJ
authors: Lembo
authors: Stéphane
authors: S
authors: Rinfret
mesh_terms: D000368:Aged; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging / Q000209:etiology; D003287:Contrast Media; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000293:injuries / Q000503:physiopathology; D003661:Decision Support Techniques; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006335:Heart Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D010490:Pericardial Effusion / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D020519:Pericardiocentesis; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media