Application of the ultrasonic technique for the pathophysiological analysis of the pericardial disease.

(1) In large pericardial effusion, echography showed a revolving motion of the heart. This characteristic motion was interfered by the pericardial adhesion. Real time cross-sectional scanning was useful for detecting the adhesion, especially the localized one. When excessive cardiac motion coexisted with tachycardia, alternation of the heart position accompanied by electrical alternans was observed. Based on the results, the mechanisms for the alternation of the heart position was discussed. (2) Echogram suggesting the pericardial thickening was found in about a half of patients with constrictive pericarditis. Another findings, which may reflect the anatomical and functional changes in constrictive pericarditis, were also presented. Although each of them is not pathognomonic, concurrence of them may suggest the presence of constrictive pericarditis. (3) Inflow velocity in jugular vein was markedly decreased in cardiac tamponade. The inspiratory increase in the inflow velocity was observed in mild cardiac tamponade, but not in severe one. Flow velocity pattern of jugular vein in constrictive pericarditis was characterized by the appearance of the reverse flow being coexistent with rapidly decelerating inflow in diastole.