Demystifying Right Atrial Diastolic Collapse: A Sensitive and Specific Marker of Cardiac Tamponade

Abstract

The echocardiographic markers that occur in sequence in cardiac tamponade are inferior vena cava plethora, right atrial diastolic collapse, exaggerated inspiratory variation in mitral and tricuspid velocities and finally right ventricular diastolic collapse. Contrary to popular belief, the degree of atrial inversion does not correlate with the presence or absence of tamponade physiology, however, the right atrial inversion time (exceeding one-third of the cardiac cycle) significantly improves the sensitivity of atrial collapse in predicting tamponade. We present here an important demonstration of fundamental physiology of respirophasic variation of right atrial collapse in cardiac tamponade.