Pericardial effusion

Case contributed by Dr Michael Rayner

Presentation

Acute central chest pain radiating to left arm. Serial ECG and troponins were negative for ischaemic pathology.

Patient Data

Age: 75 years
Gender: Male
X-ray

Current presentation Chest radiograph

On this radiograph the left heart border appears convex below the aortic arch where it was previously concave, partially obscuring the left hilum.  This finding is suggestive of a pericardial effusion.

There is new minor opacification at the left lung base that likely relates to atelectasis. 
There is eventration of the right hemidiaphragm and an old left clavicle fracture, that are unchanged compared to the prior film.

X-ray

Chest radiograph of the same patient from one year prior. 

Eventration of the right hemidiaphragm is present and an old left clavicle fracture. The image is otherwise unremarkable.

Case Discussion

The two radiographs are different projections, this aside, on the current radiograph the left heart border now appears convex below the aortic arch where it was previously concave, partially obscuring the left hilum.
Bedside echocardiogram confirmed the presence of a pericardial effusion.

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Case information

rID: 68476
Published: 9th Jun 2019
Last edited: 9th Jun 2019
System: Cardiac
Inclusion in quiz mode: Included

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