Pericardial Effusion

Table of Contents

Table of Contents

Brandon Fainstad, MD


  1. Identify key features of a cardiac silhouette suggestive of a pericardial effusion.

Teaching Instructions

Plan to spend 5-10 minutes familiarizing yourself with the animations of the power point and the key findings of this chest X-ray.

Present the image either by expanding the window (bottom right) in a browser or downloading the PowerPoint file.  Have the image pulled up in presenter mode before learners look at the screen to avoid revealing the diagnosis. Advance through the animations to prompt learners with key questions and reveal the findings, diagnosis and teaching points.  Read the following beforehand in preparation: 

Official read:

There is diffuse bibasilar hazy opacities and prominent vasculature with a visible right minor fissure all consistent with vascular congestion.  There is also a large balloon shaped cardiac silhouette with loss of the usual contours suggesting pericardial effusion.

Additional Case History:

This patient presented after missing multiple rounds of dialysis found to have volume overload and symptomatic uremia with confusion and a large pericardial effusion.  He underwent HD with a resolution of his symptoms.

Presentation Board

Take Home Point

  1. A round, balloon-shaped cardiac silhouette with loss of left-sided contours from the left pulmonary artery and the left atrium is suggestive of a pericardial effusion. 


McLoud, Boiselle, & Boiselle, Phillip M. (2010). Thoracic radiology : The requisites (2nd ed., Requisites in radiology). Philadelphia: Mosby/Elsevier.

Brandon Fainstad


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