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Cardiac tamponade

Case contributed by Dr Necip Gungor Atikeler
Diagnosis almost certain

Presentation

Lung cancer patient presenting with progressive shortness of breath.

Patient Data

Age: 80 years
Gender: Male
ct

Collapse of the right-left atrium and ventricle due to excessive pericardial effusion. There is lung mass in the right upper lobe. High density effusion with lung mass support carcinoma spread to pericardium. 

Bilateral pleural effusions, peribronchial thickening with patchy ground-glass opacities and consolidations, probably indicating vascular congestion.

Case Discussion

Pericardial effusions occur when excess fluid collects in the pericardial space. Normally pericardial sac contains approximately 30-50 mL of fluid. If the pericardial effusion becomes large enough, it can cause hemodynamic compromise, resulting in a cardiogenic shock state known as cardiac tamponade. Cardiac tamponade is a medical emergency that requires immediate treatment. Cardiac tamponade is a clinical diagnosis. CT findings can suggest this diagnosis.

This patient had both clinical and CT findings consistent with pericardial tamponade. Pericardiocentesis was performed and 500 mL of hemorrhagic fluid was drained.  

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