Pericardial effusion

Case contributed by Dr Michael Lousick

Presentation

1 week of cardiac chest pain.

Patient Data

Age: 40 years
Gender: Male

Chest

X-ray

Globular cardiomegaly and left-sided pleural effusion.

Chest

CT

Thickening of the pericardium with small volume effusion and adjacent epicardial fat stranding. Small bilateral pleural effusions, larger on the left. Widely patent epicardial coronary arteries.

Case Discussion

A pericardial effusion should be suspected when a chest radiograph shows globular cardiomegaly which was not present on prior radiographs. They can also be associated with pleural effusions which typically affect the left lung more than the right 1,2.

Note that in the case presented, the CT occurred one month after the chest radiograph, explaining the smaller than expected pericardial effusion which appeared much larger on the original chest radiograph. This patient had ECG findings typical for pericarditis.

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