What is the role of chest radiography in the workup of pericardial effusion?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Findings in chest radiography include an enlarged cardiac silhouette (so-called water-bottle heart) and a pericardial fat stripe. One third of patients have a coexisting pleural effusion. Radiography is unreliable in establishing or refuting a diagnosis of pericardial effusion. (See the image below.)

This image is from a patient with malignant perica This image is from a patient with malignant pericardial effusion. Note the "water-bottle" appearance of the cardiac silhouette in the anteroposterior (AP) chest film.

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