Pericardial effusion

Case contributed by Vincent Tatco
Diagnosis certain


Progressive exercise intolerance and shortness of breath.

Patient Data

Age: 40 years
Gender: Female

There is markedly enlarged cardiac silhouette with sagging appearance of its margins on both sides resulting to a water bottle configuration. 

Annotated image

Annotated image demonstrating the water bottle sign.

Author: Vincent Tatco

License: CC-NC-BY-SA

Case Discussion

This case is an echocardiographically proven massive pericardial effusion presenting with the "water bottle sign" on chest radiography. The fluid-filled pericardial sac casts a cardiac silhouette that resembles an old-fashioned leather water bottle. 

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