Author name: Don Gerig, RDCS

Learn how to diagnose cardiac tamponade using echocardiographic signs, Doppler clues, and hemodynamic changes. Identify critical pressure patterns before clinical shock develops.

After learning the pericardial disease spectrum in Part 1 of our pericardial disease series, the natural next step is mastering the first question in the Three-Step Framework: Is there fluid? Seems like a simple enough thing to do, right? Well, it’s not always as straightforward as you might hope.  Misinterpreting an effusion can lead to

While we often think of the pericardium as a protective sac, it’s so much more than that. Under normal conditions, it moves and stretches with every heartbeat, quietly accommodating changes in volume and pressure. 

But when it loses that flexibility, the pericardium can transmit pressure back to the heart or even restrict its ability to fill. 

And that’s where the pericardial spectrum begins. A continuum that ranges from simple effusion to hemodynamic tamponade and, in chronic or recurrent inflammation, to constriction. Understanding this progression changes the way we view the pericardium and how we interpret our echo findings.

In this article, we’ll focus specifically on the RV basal diameter measurement, explore the new severity grading, and discuss the prognostic value of this updated approach to evaluating RV size.

Few measurements in echo are as quick and powerful as the S′ velocity. With a single tissue Doppler tracing of the tricuspid annulus, we can quickly gauge whether the right ventricle is pulling its weight. 

In echocardiography, Fractional Area Change (FAC) is one of the most reliable 2D measures of right ventricular (RV) systolic function, offering a comprehensive view of right ventricular performance.

Learn how to measure TAPSE correctly, apply the new grading, recognize common pitfalls, and interpret results within the broader right-heart framework.