Inflammatory lesions of the myocardium are characterized by the following echoCG criteria: 1) an increase in heart cavities (usually 15-40% of the standard values), 2) a decrease in LV pumping function (EF, most often within 30-50%), 3) total LV hypokinesis , 4) the presence of a small pericardial effusion, 5) relative insufficiency of MK and TC (1-2 degrees less than 3 degrees).
A small effusion in the pericardium for ZLSH
Small regurgitation on MK Fig.4.1 Typical changes on EchoCG with myocarditis.
If there is a pathological effusion in the pericardial cavity, which exceeds the normal volume of serous fluid (about 20-30 ml), EchoCG reveals the separation of the pericardial sheets with the formation of echo-negative space (first behind the right atrium and the posterior wall of the LV). The movement of the parietal leaf of the pericardium decreases or disappears completely, while the excursion of the epicardial surface of the heart increases (epicardial hyperkinesis), which is an indirect sign of the presence of fluid in the pericardial cavity. Effusion completely surrounding the heart and having the smallest thickness in diastole 1.5 – 2 cm is designated as large (volume over 500 ml), moderate – with the width of the effusion less than 1.5 cm surrounding the whole heart (volume of the effusion 200 – 500 ml), a slight effusion is localized only at the back and its width is less than 1 cm (volume less than 200 ml).
Cardiac tamponade is characterized by the presence of a large pericardial effusion, compression of the right ventricle, a decrease in the size of the left ventricle during inhalation and an increase in the right, decrease in the EF of the inclination of the anterior mitral valve.