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Pericardial effusion, possibly Dressler's syndrome.

McLaughlin CTM - MedPix

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Pericardial effusion, possibly Dressler's syndrome.

History: 76 YO male presented with LE swelling and pain. Pt had MI and PTCA 3 months prior and had been SOB since that time for which he was treated with increasing doses of lasix for presumed CHF without relief. Pt was also on Coumadin for chronic atrial fibrillation with INR in therapeutic range.

Findings: PA and lateral Chest X-ray: An enlarged cardiac sillouette is demonstrated with a water-bottle shape. On the lateral view, a density following the border of the heart is seen anteriorly next to a lucent margin. Chest CT: A large pericardial effusion is demonstrated with anterior parietal pericardial thickness maximally 2 mm without pericardial enhancement.

Ddx: The differential for findings seen on CXR include pericardial effusion, dilated cardiomyopathy, CHF, and aortic dissection. The differential causes for pericardial effusion include infectious, autoimmune, neoplastic, drug induced, metabolic, sarcoidosis, pancreatitis, and trauma

Dxhow: Diagnosis was confirmed at surgery with serous fluid evacuated from pericardial space and 32 French right angle chest tube left in pericardial space.

Exam: Physical exam was significant for a fib with distant heart sounds.

No MeSH data available.


A large pericardial effusion with a normal pericardial membrane thickness.  The "water bottle" shape to the heart reflects how the pericardial sac surrounds the heart; and, extends up to the root of the great vessels.
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MPX1461_synpic20726: A large pericardial effusion with a normal pericardial membrane thickness. The "water bottle" shape to the heart reflects how the pericardial sac surrounds the heart; and, extends up to the root of the great vessels.


Pericardial effusion, possibly Dressler's syndrome.

McLaughlin CTM - MedPix

A large pericardial effusion with a normal pericardial membrane thickness.  The "water bottle" shape to the heart reflects how the pericardial sac surrounds the heart; and, extends up to the root of the great vessels.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1461&req=5

MPX1461_synpic20726: A large pericardial effusion with a normal pericardial membrane thickness. The "water bottle" shape to the heart reflects how the pericardial sac surrounds the heart; and, extends up to the root of the great vessels.

View Article: MedPix Image - MedPix Case

Affiliation: Madigan Army Medical Center

ABSTRACT

Diagnosis: Pericardial effusion, possibly Dressler's syndrome.

History: 76 YO male presented with LE swelling and pain. Pt had MI and PTCA 3 months prior and had been SOB since that time for which he was treated with increasing doses of lasix for presumed CHF without relief. Pt was also on Coumadin for chronic atrial fibrillation with INR in therapeutic range.

Findings: PA and lateral Chest X-ray: An enlarged cardiac sillouette is demonstrated with a water-bottle shape. On the lateral view, a density following the border of the heart is seen anteriorly next to a lucent margin. Chest CT: A large pericardial effusion is demonstrated with anterior parietal pericardial thickness maximally 2 mm without pericardial enhancement.

Ddx: The differential for findings seen on CXR include pericardial effusion, dilated cardiomyopathy, CHF, and aortic dissection. The differential causes for pericardial effusion include infectious, autoimmune, neoplastic, drug induced, metabolic, sarcoidosis, pancreatitis, and trauma

Dxhow: Diagnosis was confirmed at surgery with serous fluid evacuated from pericardial space and 32 French right angle chest tube left in pericardial space.

Exam: Physical exam was significant for a fib with distant heart sounds.

No MeSH data available.