Blood or Fat? Differentiating Hemopericardium versus Epicardial Fat Using Focused Cardiac Ultrasound.

Basic point-of-care ultrasound of the heart-also known as Focused Cardiac Ultrasound (FoCUS)-has emerged as a powerful bedside tool to narrow the differential diagnosis of causes of hypotension. The list of causes of hypotension that a FoCUS provider is expected to be able to recognize includes a compressive pericardial effusion due to hemopericardium (blood in the pericardial sac). But hemopericardium can be difficult to distinguish from a more common condition that is not immediately life-threatening: epicardial fat. This paper reviews illustrative images of both epicardial fat and hemopericardium to provide practice guidance to the FoCUS user on how to differentiate these two phenomena.

Duke Scholars

Author Atilio Barbeito Anesthesiology, VA Anesthesiology Service

Author Nazish Khalid Hashmi Anesthesiology, Cardiothoracic

Author Yuriy Semenovich Bronshteyn Anesthesiology, Critical Care Medicine

Author Jamie Rae Privratsky Anesthesiology, Critical Care Medicine