Faces of Pericardial Effusions

Parts
Size
Shape
Position
Character
Time Associated Findings

Infection

Inflammation

Malignancy

Small Cell Lung Carcinoma Elevated Right Sided Pressures
Not “Frank” Tamponade but Pericardiocentesis performed

Small Cell Lung Carcinoma p/w with a “White Out”
62-year-old female presents with acute dyspnea and chest pain
CT in the axial and coronal plane shows a small to moderate pericardial effusion, left lung collapse and small pleural effusion.
Echocardiogram revealed increased right sided pressures but no “frank” tamponade, and was subsequently drained
Ashley Davidoff MD TheCommonVein.net 298Lu 136725
Small Cell Lung Carcinoma Malignant Pericardial Effusion
62-year-old female presents with acute dyspnea and chest pain
CT in the axial and coronal plane shows a small to moderate pericardial effusion, left lung collapse and small pleural effusion.
Echocardiogram revealed increased right sided pressures but no “frank” tamponade, and was subsequently drained
Ashley Davidoff MD TheCommonVein.net 298Lu 136728
Small Cell Lung Carcinoma Malignant Pericardial Effusion
62-year-old female presents with acute dyspnea and chest pain
CT in the coronal and axial planes shows a small to moderate pericardial effusion, left lung collapse and small left pleural effusion.
There is evidence of elevated pressures in the right side of the heart, characterized by an enlarged IVC (3.1cms) with reflux into the hepatic veins (dark blue arrowheads , a, b, c) and reflux of contrast into the azygous vein (light blue arrowhead (d) A contrast blood level in the IVC in image c, further indicates slow flow in the IVC. tamponade would be on the differential diagnosis in this case and an echo is warranted for evaluation.
Echocardiogram revealed increased right sided pressures but no “frank” tamponade. The pericardial fluid was subsequently drained and was positive for malignant cells
Ashley Davidoff MD TheCommonVein.net 298Lu 136730

Mechanical

Atelectasis

Trauma

Metabolic

Circulatory-

Hemorrhage

Immune Infiltrative Idiopathic Iatrogenic