Final The Echo Manual DIGITAL

Chapter 12 Pericardial Diseases

CHAPTER 12 PERICARDIAL DISEASES

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FIGURE 12-22 A composite of restrictive appearing mitral inflow veloc- ity with respiratory variation of E velocity ( upper left ), hepatic vein Doppler with marked expiratory diastolic flow reversals ( arrows in upper right ), and increased mitral annulus early diastolic velocity with medial e ′ of 12 cm/s and lateral e ′ of 9 cm/s typical for “annulus reversus” at bottom. These are diag- nostic Doppler findings for constrictive pericarditis.

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FIGURE 12-23 Strain imaging from two different patients with constrictive peri- carditis. Left imaging is more characteristic with reduced longitudinal strain at the inferolateral segments, which are tethered to the pericardium. On the other hand, septal segments have increased strain value, similar to increased medial annulus e ′ velocity. Right strain imaging comes from a patient with the most thickening of the pericardium at the apical segment where strain value is reduced.

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