Whats going on in this cardiac arrest? Part 2
This post provides the explanation to the video posted yesterday- click here if you haven’t looked at that post yet.
The patient was a 56 year old male who arrived in the ED in PEA cardiac arrest. The video shows a subxiphoid view. The most striking initial observation on echo was the gap between the pericardium and the anterior wall of the RV.
Is this a pericardial effusion? Is this cardiac arrest due to tamponade?
Only looking more closely you can see that there is some RV activity but the LV is completely akinetic. This was the cause of the patients cardiac arrest. So what is is causing the gap between the RV and pericardium? This is due to a pericardial fat pad.
Look again at the gap and you will note that there are echoes within the space, it is brighter than the myocardium and moves together with the RV. Pericardial fat pads are typical seen anterior to the RV.