UMEM Educational Pearls

Title: What's the Diagnosis?

Category: Visual Diagnosis

Posted: 11/10/2014 by Haney Mallemat, MD
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Question

Parasternal long-axis of two different patients. What is the:

structure labeled “A”
structure labeled “B”
diagnosis on the left?
diagnosis on the right?

Answer

Answer:

A = Left atrium
B = Descending aorta
Left clip = Pericardial effusion
Right clip = Pleural effusion

Take home pearl: when there is fluid behind the heart, the parasternal long-axis view of the heart is helpful to distinguish between a pleural effusion and a pericardial effusion.

Step 1: Find the descending aorta and left atrium
Step 2: Is there fluid that crosses in-between the two?
- If there is, then there is a pericardial effusion
- If there is no fluid between, then it is a left pleural effusion

References

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