© 2005 Fellowship of Postgraduate Medicine
IMAGES IN MEDICINE
Cardiac tamponade
Surgical Branch, National Cancer Institute, Bethesda, MD 20892, USA; farmaj@mail.nih.gov
Keywords: cardiac tamponade; pericardial infusion
| The first 150 words of the full text of this article appear below. |
A 68 year old man was seen in clinic for progressive fatigue, dyspnoea on exertion, and cough which was progressive over one week. He denied any chest pain. He was being treated on a protocol for metastatic renal cell carcinoma. The patient initially had a chest radiograph taken, which revealed blunting of both costophrenic angles and an enlarged pericardial silhouette (fig 1
). To evaluate the pericardial fluid and to rule out progressive disease computed tomography of the chest was performed. This demonstrated bilateral pleural effusions (arrowhead) and a moderate pericardial fluid collection (arrow) with suggestion of compression of the cardiac contours (fig 2). The patient underwent an urgent transthoracic two dimensional echocardiogram, which showed a moderate circumferential pericardial effusion and significant end diastolic right atrial (arrow) and ventricular (arrowhead) collapse consistent with cardiac tamponade physiology (fig 3). The patient was taken to the operating room, where an
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