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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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