Epicardial fat can mimic pericardial effusion on transoesophageal echocardiogram

A 71-year-old woman with paroxysmal atrial fibrillation underwent transoesophageal echocardiography for evaluation of thrombus prior to atrial fibrillation ablation therapy. Transoesophageal echocardiographic images showed no thrombus but demonstrated an echo-free space adjacent to the right ventricle suggestive of a small pericardial effusion ( Figure 1A ; see Supplementary data online, Movie S1 ). Real-time three-dimensional transoesophageal echocardiographic images of the right ventricle were also suggestive of pericardial …