PMC6657625_01
Initial chest x-ray demonstrating pleural effusion and abnormal cardiac silhouette.
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fig1
Chest x-ray was remarkable for bilateral pleural effusions and prominence of the cardiopericardial silhouette consistent with pericardial effusion (Figure 1).
Demonstrates reaccumulation of pleural and pericardial fluid.
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fig2
CT thorax was obtained. CT demonstrated a reaccumulation of the right pleural effusion and persistent moderate to large pericardial effusion (Figure 2) but surprisingly showed stenosis or occlusion of the superior vena cava (Figure 3).
Demonstrates the stenotic area in the SVC around the catheter.
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fig3
CT thorax was obtained. CT demonstrated a reaccumulation of the right pleural effusion and persistent moderate to large pericardial effusion (Figure 2) but surprisingly showed stenosis or occlusion of the superior vena cava (Figure 3).
Echocardiogram prior to pericardial drain placement showing large pericardial effusion.
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fig4
Repeat echocardiogram was performed and worsening pericardial effusion was noted revealing RA collapse and diastolic RV collapse suggestive of cardiac tamponade (Figure 4).