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However, numerous extra\u2010cardiac conditions indirectly convey changes to the echocardiographic appearance through alterations in the governing physiology. Pulmonary embolism increases pulmonary arterial pressure if a sufficient cross\u2010sectional area of the pulmonary vascular bed is occluded. This may result in dilatation of the right ventricle and, in severe cases, concomitant early diastolic septal collapse into the left ventricle. Acute respiratory failure has been shown to yield a similar echocardiographic appearance in experimental conditions due to the resultant pulmonary vasoconstriction. Echocardiography in the presence of pulmonary disease can reveal underlying cardiac pathologies such as pulmonary hypertension that contribute to the clinical severity of respiratory distress. Positive pressure ventilation affects preload, afterload, and compliance of both ventricles. The echocardiographic net result cannot be uniformly anticipated, but provides information on the deciding physiology or pathophysiology. Mediastinal pathology including tumors, herniation of abdominal content, and pleural effusion can often be visualized directly with echocardiography. Mediastinal pathologies adjacent to the heart may compress the myocardium directly, thus facilitating echocardiographic and clinical signs of tamponade in the absence of pericardial effusion. In conclusion, many pathologies of extra\u2010cardiac origin influence the echocardiographic appearance of the heart. These changes do not reflect properties of the myocardium but may well be mistaken for it. Hence, these conditions are essential knowledge to all physicians performing echocardiography across the spectrum from advanced cardiological diagnostics to rapid point\u2010of\u2010care focused cardiac ultrasonography.<\/jats:p>","DOI":"10.1111\/echo.14163","type":"journal-article","created":{"date-parts":[[2018,10,19]],"date-time":"2018-10-19T03:38:42Z","timestamp":1539920322000},"page":"1847-1859","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["When appearances deceive: Echocardiographic changes due to common chest pathology"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6447-1790","authenticated-orcid":false,"given":"Henrik Lynge","family":"Hovgaard","sequence":"first","affiliation":[{"name":"Department of Cardiology Aalborg University Hospital  Aalborg Denmark"},{"name":"Department of Anaesthesiology &amp; Intensive Care Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roni Rangh\u00f8j","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital  Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian B.","family":"Laursen","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Odense University Hospital  Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian Alcaraz","family":"Frederiksen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Juhl\u2010Olsen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology &amp; Intensive Care Aarhus University Hospital  Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University  Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,10,18]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"VirnigBA ShippeeND O'DonnellB ZeglinJ ParashuramS.Trends in the use of echocardiography 2007 to 2011: Data Points #20[Internet]. 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