ARDMS Echo Pericardial Disease 1 — Questions and Answers
Question 1: What is the normal volume of pericardial fluid in a healthy adult?
- 5–10 mL
- 15–50 mL (Correct answer)
- 50–100 mL
- 100–150 mL
Correct answer: 15–50 mL
The normal pericardial sac contains approximately 15–50 mL of serous fluid that acts as a lubricant between the visceral and parietal pericardium.
Question 2: On the parasternal long-axis view, how is a pericardial effusion distinguished from a left pleural effusion?
- Pericardial effusion crosses posterior to the descending aorta
- Pericardial effusion is bounded anteriorly by the descending aorta (Correct answer)
- Pleural effusion appears only during systole
- Pericardial effusion is always larger than pleural effusion
Correct answer: Pericardial effusion is bounded anteriorly by the descending aorta
On the parasternal long-axis view, pericardial effusion lies anterior to the descending aorta, whereas a pleural effusion extends posterior to it.
Question 3: According to standard echocardiographic grading, a small pericardial effusion is defined as an echo-free space measuring less than:
- 5 mm
- 10 mm (Correct answer)
- 15 mm
- 20 mm
Correct answer: 10 mm
A small pericardial effusion is classified as an echo-free separation of less than 10 mm measured in the parasternal long-axis view during diastole.
Question 4: Which condition is characterized by fibrous thickening, scarring, and sometimes calcification of the pericardium that impairs cardiac filling?
- Pericardial effusion
- Cardiac tamponade
- Constrictive pericarditis (Correct answer)
- Pericardial cyst
Correct answer: Constrictive pericarditis
Constrictive pericarditis results from scarring and loss of pericardial elasticity, creating a rigid shell around the heart that restricts ventricular filling.
Question 5: What is the most common echocardiographic finding in acute pericarditis?
- Pericardial thickening > 4 mm
- Pericardial effusion (Correct answer)
- Paradoxical septal motion
- Dilated inferior vena cava
Correct answer: Pericardial effusion
Pericardial effusion is detected in the majority of acute pericarditis cases and is the most frequently observed echocardiographic abnormality.
Question 6: Which echocardiographic appearance best describes a large circumferential pericardial effusion?
- Hyperechoic rim surrounding the heart
- Echo-free space surrounding all cardiac chambers (Correct answer)
- Increased echogenicity within the pericardial sac
- Septal bounce on inspiration
Correct answer: Echo-free space surrounding all cardiac chambers
A large pericardial effusion appears as a circumferential echo-free (anechoic) space that encircles all four cardiac chambers.
Question 7: Pericardial cysts are benign congenital lesions most commonly found at which location on echocardiography?
- Left cardiophrenic angle
- Right cardiophrenic angle (Correct answer)
- Posterior mediastinum near the pulmonary veins
- Anterior to the aortic root
Correct answer: Right cardiophrenic angle
Pericardial cysts are fluid-filled, thin-walled structures located most often at the right cardiophrenic angle and appear as anechoic masses on echocardiography.
ARDMS Echo Pericardial Disease 1
What is the normal volume of pericardial fluid in a healthy adult?