Images in Clinical Medicine

Cardiac Tamponade in Dressler's Syndrome

Bernard Paelinck, M.D., and Paul A. Dendale, M.D., Ph.D.

N Engl J Med 2003; 348:e8June 5, 2003

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Video

Cine Magnetic Resonance Imaging Showing a Swinging Motion of the Heart.

A 57-year-old woman was referred to our clinic because of malaise, dyspnea, and pedal edema four weeks after an extensive myocardial infarction. Physical examination revealed jugular venous distention and pulsus paradoxus but no pericardial friction rub. Cine magnetic resonance imaging showed massive pericardial effusion (arrows) and a swinging motion of the heart (video clip). Late diastolic inversion of the right atrium confirmed cardiac tamponade. Imaging also showed myocardial thinning and extensive dyskinesia in the infarcted area at the apex and inferoseptal wall (arrowheads). Signs of cardiac tamponade disappeared quickly during percutaneous draining of 600 ml of serohemorrhagic pericardial fluid.

Bernard Paelinck, M.D.
Paul A. Dendale, M.D., Ph.D.
University Hospital Antwerp, 2650 Edegem, Belgium