Presentation
Chest pain and shortness of breath.
Patient Data
There is a large pericardial effusion measuring up to 23mm posterior to the left ventricle. There is no appreciable enhancement and evidence of hemopericardium. A small left pleural effusion is also present.
There is an incidental finding of a lobulated, low density lesion within the uncinate process of the pancreatic head. There is no dilated pancreatic duct or CBD. Differentials include duodenal diverticulum and IPMN.
CXR 1 month prior demonstrates an enlarged cardiac silhouette without evidence of consolidation or pleural effusion.
Case Discussion
Pericardial effusions may be primary idiopathic, or secondary to malignancy, infection, uremia, myocardial infarction (known as Dressler Syndrome), and connective tissue disorders 1.
Pericardial effusion secondary to pancreatic cancer is rare 2. It is most frequently associated with metastatic non-small cell lung cancer, breast cancer, esophageal cancer and lymphoma 3.
Transthoracic or transesophageal echocardiogram is the diagnostic test of choice for assessing the functional impact of the effusion 4.
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