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Key Image

Axial contrast enhanced CT (pulmonary artery CTA, PE protocol)

Key Findings

Thickening of the pericardial sac (red arrows). No evidence for thrombus in the pulmonary arteries.

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Diagnosis

Pericardial Effusion

Discussion

Pericardial Effusion most often presents with dyspnea and fatigue.

Etiology may be from many different causes, including serous fluid, blood, lymph or fibrin. This case demonstrated water density. No signs for cardiac tamponade present in this case.

Cardiac Tamponade may be present in ~50% of cases of pericardial effusion. Cardiac tamponade is a life-threatening condition that results from slow or rapid heart compression secondary to accumulation of fluid, pus, blood, gas, or tissue within the pericardial cavity. CT findings associated with cardiac tamponade include:
- pericardial effusion (usually large) with distention of the SVC & IVC
- reflux of contrast material into the azygos vein and inferior vena cava
- deformity and compression of the cardiac chambers
- angulation or bowing of the interventricular septum.

References / Resources

Additional Information:

1. Dahnert*: 603
2. Primer*:
3. Related Article:

   Restrepo CS. "Imaging findings in cardiac tamponade with emphasis on CT." RadioGraphics 2007, 27(6): 1595 - 1610

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