Ultrasound Case 003


72 year old man with a history of mesothelioma presents with increasing shortness of breath.

View 2
View 3
subcostal view
Describe and interpret these scans

Image 1: A moderate sized pleural effusion is present. Fanning through the effusion the descending aorta is seen, then the heart – which is surrounded by a large pericardial effusion.

Image 2: Using the echo probe the pericardial effusion is again seen through the pleural effusion.

Image 3: Subcostal view: taken with the curvilinear probe confirms a large pericardial effusion with some right sided chamber collapse.


Pleural effusion and pericardial effusion with echocardiographic signs of tamponade

Rapid assessment of the chest in a deteriorating patient with known mesothelioma in whom previous pleural fluid drainage has been performed is extremely useful.

A pneumothorax, recurrent pleural effusion, or progression of solid malignancy may be playing a part.

Keeping an open mind is always important and in this case through the pleural effusion a large pericardial effusion is seen.



Dr James Rippey LITFL Ultrasound SonoCPD

An Emergency physician based in Perth, Western Australia. Professionally my passion lies in integrating advanced diagnostic and procedural ultrasound into clinical assessment and management of the undifferentiated patient. Sharing hard fought knowledge with innovative educational techniques to ensure knowledge translation and dissemination is my goal. Family, wild coastlines, native forests, and tinkering in the shed fills the rest of my contented time. | SonoCPDUltrasound library | Top 100 | @thesonocave |

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