Use of venous contrast echocardiography for diagnosis of cardiac tamponade

Abstract Two-dimensional echocardiography is the imaging modality of choice for detecting pericardial effusion. 1 If right ventricular and right atrial collapse is clearly demonstrated, the diagnosis of cardiac tamponade can be made with relative certainty. 2 It may be difficult to identify right-sided heart chamber collapse, however, if the image is of poor quality. Venous contrast echocardiography has been safely used in the diagnosis of intracardiac shunts and abnormal cardiac anatomy. 3,4 In pericardial effusion, its use has been limited to confirming proper needle tip position during pericardiocentesis. 5,6 To our knowledge venous contrast echocardiography has not been reported to facilitate the diagnosis of cardiac tamponade. We report 2 cases where its use was helpful in diagnosing cardiac tamponade.