{"id":41804,"date":"2021-01-12T20:53:08","date_gmt":"2021-01-12T15:23:08","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=41804"},"modified":"2021-01-12T20:53:08","modified_gmt":"2021-01-12T15:23:08","slug":"septal-bounce-and-septal-shudder-in-constrictive-pericarditis","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\/","title":{"rendered":"Septal bounce and septal shudder in constrictive pericarditis"},"content":{"rendered":"<h2><span style=\"color: #008000;\">Septal bounce and septal shudder in constrictive pericarditis<\/span><\/h2>\n<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/tRwoxs6uvWc\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><strong><span style=\"color: #0000ff;\">Septal bounce<\/span><\/strong><\/p>\n<p><span style=\"color: #ff0000;\">Septal bounce<\/span> is also called <span style=\"color: #0000ff;\">respirophasic ventricular septal shift<\/span> [1, 2]. It is an early diastolic posterior motion of the interventricular septum.\u00a0 Septal bounce is a sign of ventricular interdependence noted in constrictive pericarditis. The sign may be seen on echocardiography, cardiac magnetic resonance imaging and cardiac computed tomography. Mechanism has been studied by simultaneous cardiac catheterization and echocardiography [2]. Septal bounce was the most consistent sign among 39 cases of constrictive pericarditis evaluated by two independent observers in a study [3]. <span style=\"color: #ff00ff;\">Septal &#8216;bounce&#8217; can occur in right ventricular pacing and left bundle branch block<\/span>. But this occurs in early systole and has been called <span style=\"color: #ff00ff;\">septal flash<\/span>. Septal bounce occurred in 93% cases of constrictive pericarditis and 31% of other cases in a study [4]. Ventricular septal shift has been included as one of the five Mayo Clinic echocardiographic criteria for constrictive pericarditis [4]. Increased filling of right sided chambers and decreased filling of left sided chambers in inspiration causes a shift of the septum towards the left ventricle. In expiration, increased filling of left sided chambers and decreased filling of right sided chambers cause a shift of the septum towards the right ventricle. This is respirophasic ventricular septal shift. It typically needs a 10 beat long 2-D echo or M-Mode for documentation [4].<\/p>\n<p>A systematic review noted almost universal presence of septal bounce on magnetic resonance imaging in constrictive pericarditis with sensitivity of 90-96% and specificity of 85-100% [5].<\/p>\n<p><strong><span style=\"color: #0000ff;\">Septal shudder<\/span><\/strong><\/p>\n<p>Septal shudder is an abnormal beat-to-beat septal motion, seen in constrictive pericarditis, but may also be seen in conduction abnormalities and post operative septum [4]. Septal shudder occurred in 96% cases of constrictive pericarditis and 44% of other cases. Due to lack of specificity, septal shudder was not included in the Mayo clinic criteria for echocardiographic findings in constrictive pericarditis.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>Roland R. Brandt, Jae K. Oh. <a href=\"https:\/\/www.escardio.org\/Journals\/E-Journal-of-Cardiology-Practice\/Volume-15\/Constrictive-pericarditis-role-of-echocardiography-and-magnetic-resonance-imaging\">Constrictive pericarditis: role of echocardiography and magnetic resonance imaging<\/a>. Vol. 15, N\u00b0 23 &#8211; 22 Nov 2017.<\/li>\n<li>Megan Coylewright, Terrence D Welch, Rick A Nishimura. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/23740298\/\">Mechanism of septal bounce in constrictive pericarditis: a simultaneous cardiac catheterisation and echocardiographic study<\/a>. Heart. 2013 Sep;99(18):1376.<\/li>\n<li>R B Himelman, E Lee, N B Schiller. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/3272782\/\">Septal bounce, vena cava plethora, and pericardial adhesion: informative two-dimensional echocardiographic signs in the diagnosis of pericardial constriction<\/a>. J Am Soc Echocardiogr. Sep-Oct 1988;1(5):333-40.<\/li>\n<li>Terrence D Welch, Lieng H Ling, Raul E Espinosa, Nandan S Anavekar, Heather J Wiste, Brian D Lahr, Hartzell V Schaff, Jae K Oh. <a href=\"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/circimaging.113.001613\">Echocardiographic diagnosis of constrictive pericarditis: Mayo Clinic criteria<\/a>. Circ Cardiovasc Imaging. 2014 May;7(3):526-34.<\/li>\n<li>Sivakumar Ardhanari, Bharath Yarlagadda, Vishal Parikh, Kevin C Dellsperger, Anand Chockalingam, Sudarshan Balla, Senthil Kumar. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/28228308\/\">Systematic review of non-invasive cardiovascular imaging in the diagnosis of constrictive pericarditis<\/a>. Indian Heart J. Jan-Feb 2017;69(1):57-67.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Septal bounce and septal shudder in constrictive pericarditis Septal bounce Septal bounce is also called respirophasic ventricular septal shift [1, 2]. It is an early diastolic posterior motion of the interventricular septum.\u00a0 Septal bounce is a sign of ventricular interdependence noted in constrictive pericarditis. The sign may be seen on echocardiography, cardiac magnetic resonance imaging [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":41826,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[20,8],"tags":[3293,3513,3514,3520,3521,4160],"class_list":["post-41804","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cardiac-magnetic-resonance-imaging","category-echocardiogram-library","tag-respirophasic-ventricular-septal-shift","tag-septal-bounce","tag-septal-bounce-in-constrictive-pericarditis","tag-septal-shudder","tag-septal-shudder-in-constrictive-pericarditis","tag-ventricular-interdependence"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Septal bounce and septal shudder in constrictive pericarditis - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Septal bounce and septal shudder in constrictive pericarditis - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Septal bounce and septal shudder in constrictive pericarditis Septal bounce Septal bounce is also called respirophasic ventricular septal shift [1, 2]. It is an early diastolic posterior motion of the interventricular septum.\u00a0 Septal bounce is a sign of ventricular interdependence noted in constrictive pericarditis. The sign may be seen on echocardiography, cardiac magnetic resonance imaging [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2021-01-12T15:23:08+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Septal bounce and septal shudder in constrictive pericarditis\",\"datePublished\":\"2021-01-12T15:23:08+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\\\/\"},\"wordCount\":450,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"respirophasic ventricular septal shift\",\"septal bounce\",\"septal bounce in constrictive pericarditis\",\"septal shudder\",\"septal shudder in constrictive pericarditis\",\"ventricular interdependence\"],\"articleSection\":[\"Cardiac Magnetic Resonance imaging\",\"Echocardiography\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/septal-bounce-and-septal-shudder-in-constrictive-pericarditis\\\/\",\"name\":\"Septal bounce and septal shudder in constrictive pericarditis - 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