Question

46 year-old female found unresponsive at a party. EMS transports the patient in cardiac arrest. A parasternal-long axis view of the heart is obtained during the pulse check. What's the diagnosis?

 

Answer

Hemopericardium

The heterogeneous appearance of the pericardial fluid indicates that is likely a complex pericardial effusion; the fluid could be blood, pus, or a malignant effusion.

Differential diagnosis of hemopericardium includes:

• Ascending aortic dissection
• Cardiac free-wall rupture
• Blunt / penetrating trauma
• Coagulopathies
• Metastasis to the pericardium

Based on this initial ECHO, a pericardiocentesis was performed and blood was aspirated.

References

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