Presentation
Presented with breathlessness and clinically was in cardiac failure.
Patient Data
A large pericardial effusion was diagnosed by ultrasound and a pericardial tap was performed under ultrasound guidance. The air was inadvertently introduced during the procedure.
Initial chest imaging demonstrated bilateral pleural effusions and a globular enlarged cardiac shadow. Differential for the cardiac shadow on plain film would include cardiomegaly, cardiomyopathy or pericardial effusion. A pericardial effusion can be easily diagnosed by ultrasound.
Case Discussion
Gas can be inadvertently introduced during a pericardial or pleural effusion tap. Testing of the pericardial fluid demonstrated an exudate, not a transudate. In this setting, with tuberculosis endemic, treatment was given and the pericardial effusion resolved.