Massive pericardial effusion

Case contributed by Dr Olumuyiwa Ifedayo Ajayi

Presentation

Chest pain with tightness, difficulty with breathing. Fatigue.

Patient Data

Age: 40 years
Gender: Female
CT

Axial unenhanced and contrast-enhanced chest CT demonstrate a relatively evenly distributed massive pericardial effusion. The depth of the effusion is greater than 40 mm.

Posteriorly displaced epicardial fat pad by large amount of low attenuation fluid surrounding the heart.

Small volume left pleural effusion is due to congestive cardiac failure.

Case Discussion

Massive pericardial effusion in a patient with end-stage renal disease in uremic state.

The patient's condition worsened due to hemodynamic derangement as she clinically elicited signs of cardiac tamponade.

She underwent immediate pericardiocentesis.

Causes of pericardial effusion include (not exhaustive):

  • Infection/ Inflammatory
  • Autoimmune (Scleroderma, SLE)
  • Uremia
  • Drug-induced
  • Trauma/ iatrogenic
  • Malignancy
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Case information

rID: 69169
Published: 2nd Jul 2019
Last edited: 14th Aug 2019
System: Chest
Inclusion in quiz mode: Included

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