Key result
2D echocardiography can misdiagnose large amounts of pericardial fat as a large pericardial effusion.
Case Report (n=1)
This case highlights a potential diagnostic pitfall where large amounts of pericardial fat can mimic a pericardial effusion on 2D echocardiography.
Echocardiographers should consider fat mimics in apparent effusions; this case leaves open the need for confirmatory imaging protocols.
A 78-year-old overweight woman with diabetes mellitus, bronchial asthma, and Sheehan's syndrome on chronic steroid therapy presented with mild short-lived hematemesis, significant hypotension disproportionate to the degree of bleeding and radiographic evidence of cardiomegaly. Endoscopy showed duodenal ulcer. During evaluation of the unexplained brief hypotension and cardiomegaly, 2D-echocardiogram demonstrated anterior and posterior echo-free spaces consistent with large pericardial effusion (PE). However, subsequent elective surgical pericardiotomy unexpectedly revealed large amounts of pericardial fat. Pericardial fat was also noted on magnetic resonance imaging of the chest. Our case illustrates a potential pitfall of 2D-echocardiography in the diagnosis of PE.
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Kanna et al. (2006) conducted a case report in Pericardial fat mimicking pericardial effusion (n=1). 2D-echocardiography vs. Surgical pericardiotomy and MRI was evaluated on Diagnosis of pericardial effusion vs pericardial fat. Two-dimensional echocardiography misdiagnosed large amounts of pericardial fat as a large pericardial effusion, illustrating a potential diagnostic pitfall.
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