Water bottle sign (heart)

Dr Vikas Shah and A.Prof Frank Gaillard et al.

The water bottle sign or configuration refers to the shape of the cardiac silhouette on erect frontal chest x-rays in patients who have a very large pericardial effusion. Typically the effusion has accumulated over many weeks to months (e.g. in patients with malignancy) and the pericardium has gradually stretched. The fluid, often measuring a litre or more, causes the pericardium to sag, mimicking an old-fashioned water bottle sitting on the bench.

Chest x-ray
Inspired signs
Share article

Article information

rID: 15496
System: Chest
Section: Signs
Synonyms or Alternate Spellings:
  • Water bottle configuration
  • Water bottle heart

Support Radiopaedia and see fewer ads

Cases and figures

  • Drag
    Case 1
    Drag here to reorder.
  • Drag
    Pericardial effusion
    Case 2
    Drag here to reorder.
  • Drag
    Case 3: annotated image
    Drag here to reorder.
  • Drag
    Case 4
    Drag here to reorder.
  • Drag
    Case 5
    Drag here to reorder.
  • Updating… Please wait.

    Alert accept

    Error Unable to process the form. Check for errors and try again.

    Alert accept Thank you for updating your details.