Pericardial Effusion | The Common Vein

WATER BOTTLE HEART
X-ray shows the typical appearance of a “water bottle heart? characteristic of a pericardial of a large pericardial effusion.
Ashley Davidoff MD

Atlas

Effusion Type	T1W FSE	T2W FSE

Transudate	low	high
exudate	medium	high
proteinaceous	high	very high
acute hemorrhage	homogeneous high	homogeneous low
subacute or chronic hemorrhage	heterogeneous	subacute bright or dark chronic usually dark

Sandwich Sign – Oreo Cookie Sign of a Pericardial Effusion on Lateral CXR

76031c01c heart cardiac pericardium pericardial effusion enlarged fluid between two fat layers sandwich sign visceral pericardium parietal pericardium epicardial fat pericardial fat plain film CXR plain X-ray Courtesy Rebecca Schwartz MD

Sandwich Sign of a Pericardial Effusion on Lateral CXR

76031c01d heart cardiac pericardium pericardial effusion enlarged fluid between two fat layers sandwich sign visceral pericardium parietal pericardium epicardial fat pericardial fat plain film CXR plain X-ray Courtesy Rebecca Schwartz MD

SLE AND LARGE HEART
2 views of the chest of a 54 year old female with SLE and Sjogren’s syndrome show a slightly enlarged heart in the PA projection and an unusually prominent and rotund IVC (red arrowhead)
Ashley Davidoff MD
key words
pericarditis, pericardial effusion, SLE

SLE AND LARGE HEART
Coronal (above) and axial images CT showing the Rv and LV of a 54 year old female with SLE and Sjogren’s syndrome. A small pericardial effusion is noted accounting for the cardiomegaly on CXR.
Ashley Davidoff MD
key words SLE, pericarditis, pericardial effusion

SLE AND LARGE HEART
The axial image (a) and correlative sagittal image (b) show a prominent IVC (white arrowhead) accounting in part for the rotund and prominent IVC shadow on the CXR. Image c and d show that the pericardial effusion itself also contributes to the posterior shadow (pink arrowheads) The patient is a 54 year old female with SLE and Sjogren’s syndrome with active SLE and pericarditis and pericardial effusion.
Ashley Davidoff MD
key words SLE, pericarditis, pericardial effusion

Atelectasis of the Left Lung, Pleural Effusion, Pericardial Tamponade s/p AVR
60 year old male s/p AVR presents with acute respiratory distress. CT scan shows total collapse of left lung, associated with a large effusion The atelectasis is either due to the associated effusion or an obstructing mucus plu. There is a large pericardial effusion with tamponade physiology by echo
Ashley Davidoff MD TheCommonVein.net

Oreo Cookie Sign

Constriction

In CP, the size of the heart is usually normal; flattening of the right ventricle and curving of the interventricular septum to the left . The azygos vein and superior vena cava (SVC) are commonly dilated.

Web References

ACC – CXR and pericardial Disease

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Sandwich Sign of a Pericardial Effusion on Lateral CXR


76031c01d heart cardiac pericardium pericardial effusion enlarged fluid between two fat layers sandwich sign visceral pericardium parietal pericardium epicardial fat pericardial fat plain film CXR plain X-ray Courtesy Rebecca Schwartz MD



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Sandwich Sign of a Pericardial Effusion on Lateral CXR


76031c01d heart cardiac pericardium pericardial effusion enlarged fluid between two fat layers sandwich sign visceral pericardium parietal pericardium epicardial fat pericardial fat plain film CXR plain X-ray Courtesy Rebecca Schwartz MD



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76031c01c heart cardiac pericardium pericardial effusion enlarged fluid between two fat layers sandwich sign visceral pericardium parietal pericardium epicardial fat pericardial fat plain film CXR plain X-ray Courtesy Rebecca Schwartz MD



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76031c01c heart cardiac pericardium pericardial effusion enlarged fluid between two fat layers sandwich sign visceral pericardium parietal pericardium epicardial fat pericardial fat plain film CXR plain X-ray Courtesy Rebecca Schwartz MD



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Effusion Type
T1W FSE
T2W FSE







Transudate
low
high


exudate
 medium
high


 proteinaceous
 high
 very high


 acute hemorrhage
 homogeneous high
 homogeneous low


subacute or chronic hemorrhage
 heterogeneous
subacute bright or dark
chronic usually dark



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Effusion Type
T1W FSE
T2W FSE







Transudate
low
high


exudate
 medium
high


 proteinaceous
 high
 very high


 acute hemorrhage
 homogeneous high
 homogeneous low


subacute or chronic hemorrhage
 heterogeneous
subacute bright or dark
chronic usually dark



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    [firstElementChild] => 
    [lastElementChild] => 
    [childElementCount] => 0
    [previousElementSibling] => (object value omitted)
    [nextElementSibling] => 
    [nodeName] => td
    [nodeValue] => T2W FSE
    [nodeType] => 1
    [parentNode] => (object value omitted)
    [childNodes] => (object value omitted)
    [firstChild] => (object value omitted)
    [lastChild] => (object value omitted)
    [previousSibling] => (object value omitted)
    [nextSibling] => (object value omitted)
    [attributes] => (object value omitted)
    [ownerDocument] => (object value omitted)
    [namespaceURI] => 
    [prefix] => 
    [localName] => td
    [baseURI] => 
    [textContent] => T2W FSE
)

DOMElement Object
(
    [schemaTypeInfo] => 
    [tagName] => td
    [firstElementChild] => 
    [lastElementChild] => 
    [childElementCount] => 0
    [previousElementSibling] => (object value omitted)
    [nextElementSibling] => (object value omitted)
    [nodeName] => td
    [nodeValue] => T1W FSE
    [nodeType] => 1
    [parentNode] => (object value omitted)
    [childNodes] => (object value omitted)
    [firstChild] => (object value omitted)
    [lastChild] => (object value omitted)
    [previousSibling] => (object value omitted)
    [nextSibling] => (object value omitted)
    [attributes] => (object value omitted)
    [ownerDocument] => (object value omitted)
    [namespaceURI] => 
    [prefix] => 
    [localName] => td
    [baseURI] => 
    [textContent] => T1W FSE
)

DOMElement Object
(
    [schemaTypeInfo] => 
    [tagName] => td
    [firstElementChild] => 
    [lastElementChild] => 
    [childElementCount] => 0
    [previousElementSibling] => 
    [nextElementSibling] => (object value omitted)
    [nodeName] => td
    [nodeValue] => Effusion Type
    [nodeType] => 1
    [parentNode] => (object value omitted)
    [childNodes] => (object value omitted)
    [firstChild] => (object value omitted)
    [lastChild] => (object value omitted)
    [previousSibling] => (object value omitted)
    [nextSibling] => (object value omitted)
    [attributes] => (object value omitted)
    [ownerDocument] => (object value omitted)
    [namespaceURI] => 
    [prefix] => 
    [localName] => td
    [baseURI] => 
    [textContent] => Effusion Type
)

Constriction

Web References

TCV