Pericardial effusion

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Breathlessness. Left sided crackles to mid zone.

Patient Data

Age: 80 years
Gender: Female
x-ray

Marked enlargement of the cardiac silhouette, even for an AP projection. Small right pleural effusion and small-to-moderate left pleural effusion. 

Case Discussion

There is a very long list for an enlarged cardiac silhouette, but when one is as big as this, and with a slightly globular shape then pericardial effusion should be near the top. Comparison with prior chest x-rays is always very useful, and will often show a marked change in size in a short timeframe, confirming the diagnosis. 

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