On FAST examination, the pericardial space is interrogated via the subxiphoid window. Which of the following most accurately indicates a positive (haemopericardium) finding?

• A Echogenic band posterior to the left ventricle
• B Collapse of the right ventricle during systole
• C Bidirectional flow in the coronary sinus
• D Anechoic fluid rim >5 mm anterior to the right ventricle ✓

Explanation

Haemopericardium on FAST is identified as an anechoic (dark) stripe anterior to the right ventricle; a rim >5 mm is generally considered positive. Right ventricular diastolic collapse (not systolic) is the echocardiographic sign of tamponade. An echogenic posterior band may represent the posterior pericardium or artefact. Coronary sinus flow is not assessed on FAST.

Reference: Grainger & Allison's Diagnostic Radiology, 7th ed.

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