PMC4145743_01
The CT study performed upon emergency department arrival. The heart and mediastinum are dramatically displaced to the left. The heart has migrated posteriorly to rest on the atelectatic left lower lobe of the lung (black arrows). The white arrows demarcate the edges of the pericardium through which the heart has herniated.
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CT scan of the chest was consistent with an empyema, complete atelectasis of the left lower lobe, and a substantial shift of the mediastinum and heart into left chest (Figure 1).
The CT study performed on postoperative day 7 that shows dramatic improvement in the cardiac position as well as decreased atelectasis of the lower lobe of the left lung.
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Through the remainder of the hospital stay the patient showed progressive improvement (Figure 2) and was discharged home 25 days after admission, with a blood pressure of 106/60 and a heart rate of 67 beats per minute.