Thursday, 27 March 2014

A big heart.

Can you spot anything abnormal on this CXR?

The CXR shows globular enlargement of the cardiac shadow, sometimes known as the "water bottle sign". This is due to a pericardial effusion. The lungs and pleural spaces are clear. A coronal view on CT confirms a large pericardial effusion:



Causes of a pericardial effusion include:
  • Inflammation: following a myocardial infarction, known as Dresslers syndrome, or in rheumatological disorders.
  • Radiotherapy
  • Infections: viruses, atypical pathogens such as mycobacterium tuberculosis
  • Malignancy
  • Idiopathic: no known cause