Hemopericardium refers to the presence of blood within the pericardial cavity, i.e. a sanguineous pericardial effusion. If enough blood enters the pericardial cavity, then a potentially fatal cardiac tamponade can occur.
On this page:
Pathology
Etiology
There is a very long list of causes 1,2 but some of the more common are:
ruptured myocardial infarction
ruptured left ventricular aneurysm
-
trauma
blunt/penetrating/deceleration
iatrogenic, e.g. pacemaker wire insertion
ruptured coronary artery aneurysm
post-thrombolysis
Radiographic features
Plain radiograph
enlargement of the cardiac silhouette may be present but chest x-rays are insensitive and non-specific
the "straight left heart border" is an infrequent sign with low sensitivity (~40%) for hemopericardium in penetrating trauma patients 3
the Oreo cookie sign on lateral CXR
CT
pericardial effusion with a density >35 HU 4 or that of water 2,5
Differential diagnosis
vicarious contrast material excretion into the pericardium post cardiac catheterization may mimic hemopericardium on CT
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