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Case Reports
. 2009 Jan 22:7:3.
doi: 10.1186/1476-7120-7-3.

Pseudo cardiac tamponade in the setting of excess pericardial fat

Thang Nguyen  1 , Kanwal Kumar, Andrew Francis, Jonathan R Walker, Michael Raabe, Shelley Zieroth, Davinder S Jassal
Affiliations
Case Reports

Pseudo cardiac tamponade in the setting of excess pericardial fat

Thang Nguyen et al. Cardiovasc Ultrasound. .

Abstract

Cardiac tamponade is the phenomenon of hemodynamic compromise caused by a pericardial effusion. Following a myocardial infarction, the most common causes of pericardial fluid include early pericarditis, Dressler's syndrome, and hemopericardium secondary to a free wall rupture. On transthoracic echocardiography, pericardial fluid appears as an echo-free space in between the visceral and parietal layers of the pericardium. Pericardial fat has a similar appearance on echocardiography and it may be difficult to discern the two entities. We present a case of a post-MI patient demonstrating pseudo tamponade physiology in the setting of excessive pericardial fat.

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Figures

Figure 1
Figure 1
A transthoracic echocardiogram parasternal long axis view demonstrating a mildly dilated left ventricle and global LV systolic dysfunction.
Figure 2
Figure 2
A transthoracic echocardiogram parasternal short axis view demonstrating a mildly dilated left ventricle and global LV systolic dysfunction.
Figure 3
Figure 3
A transthoracic echocardiogram 4 chamber view from subxiphoid approach representing a 25 mm echolucent region adjacent to the right ventricular free wall and right atrium, presumed to be due to a pericardial effusion.
Figure 4
Figure 4
A transthoracic echocardiographic short axis view from subxiphoid view representing echodense material attached to the right ventricular wall, presumed to be thrombus (arrows).
Figure 5
Figure 5
A subxiphoid view of the dilated inferior vena cava greater than 2.0 cm.
See this image and copyright information in PMC

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