Image 2
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Image 2
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There is a modest pericardial effusion which has greater density than the heart.
This is a clotting haemopericardium. The amount of blood in the pericardium
is insufficient to cause hypovolaemic shock. It is enough to cause some tamponade,
which must be part of the picture here. However we have noticed that acute blood
in the pericardium has a strangely depressant effect on left ventricular function.
Image 2 is a saggital reconstruction of the CT , ungated and with poor breath
holding but nevertheless good enough to reassure the cardiologist that needle
drainage from the sub-xiphisternal approach has a good target.