What is the first line imaging modality for suspected pericardial effusion?

The first line imaging modality for suspected pericardial effusion is the echocardiogram. This choice is correct because echocardiography provides real-time imaging of the heart and surrounding structures, allowing for direct visualization of fluid accumulation in the pericardial space. It is a readily available, non-invasive, and highly effective method for diagnosing pericardial effusion.

Echocardiography can also assess the hemodynamic significance of the effusion, helping to determine whether it requires intervention. It allows for both quantification of the fluid volume and evaluation of the heart's contractile function, which are crucial for guiding clinical management.

Other imaging modalities such as CT scans and X-rays may be used to further evaluate the condition, but they are not typically the initial approach due to factors such as availability and the need for specialized settings. Nuclear medicine scans are not standard for this purpose and are utilized primarily in specific scenarios like assessing myocardial perfusion rather than for evaluating pericardial effusion.