The mitral valve flow velocity profile (Figure 7) shows a marked respiratory variation of flow during respiration (asterisks: peak E wave); However, LV outflow does not decrease significantly during respiration (Figure 8). In summary, the exam shows that the moderate pericardial effusion localized lateral to the right ventricle is hemodynamically significant, but has not yet reached the point to be defined as tamponade.
The patient was asymptomatic at rest (in hospital post-operative period) and managed conservatively.
Figure 9 shows an almost complete regression of the effusion lateral to the right heart, after 1 week. The right atrial wall shows only active atrial contraction. All the pre-tamponade echocardiographic signs described above have regressed.