Question

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

1. structure labeled “A”
2. structure labeled “B”
3. diagnosis on the left?
4. diagnosis on the right?

Answer

Answer: 

1. A = Left atrium
2. B = Descending aorta
3. Left clip = Pericardial effusion
4. 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

Follow me on Twitter (@criticalcarenow) or Google+ (+criticalcarenow)