Presentation
Patient suffering from hypertrophic cardiomyopathy that required a pacemaker. Constrictive pericarditis associated with pleural effusion
Patient Data
On the lateral CXR projection, the thickened pericardium is of increased density (red arrow) leaving a low density space posteriorly (yellow arrow) corresponding to the epicardic fat pad and a low density space anteriorly corresponding to the retrosternal fat pad, known as "oreo cookie" sign.
The thickened pericardium having a fat density space posteriorly corresponding to the epicardic fat pad and another fat density space anteriorly corresponding to the retrosternal fat pad.
Case Discussion
This case is an example of oreo cookie sign of pericardial effusion on CXR.