Review

Don’t judge a book by its cover: Unusual presentations of pericardial disease

William A. Schiavone, DO and David S. Majdalany, MD
Cleveland Clinic Journal of Medicine February 2025, 92 (2) 109-116; DOI: https://doi.org/10.3949/ccjm.92a.24065

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    Artist’s drawing of the reflections of the anterior parietal pericardium clockwise on the superior vena cava, ascending aorta, pulmonary trunk, and diaphragm.

  • Figure 2
    Figure 2

    Artist’s drawing of posterior parietal pericardial reflections on the superior vena cava, ascending aorta, pulmonary trunk, pulmonary veins, diaphragm, and inferior vena cava.

  • Figure 3
    Figure 3

    Posteroanterior chest radiograph in a hypothyroid patient with a large pericardial effusion and prominent azygos vein (arrow).

    Reprinted from CXRs in Cardiovascular Disease, copyright 2023 by RYC, LLC; used with permission of RYP, LLC, all rights reserved.

  • Figure 4
    Figure 4

    Posteroanterior chest radiograph of the same patient after 2 months of thyroid hormone replacement therapy.

    Reprinted from CXRs in Cardiovascular Disease, copyright 2023 by RYC, LLC; used with permission of RYP, LLC, all rights reserved.

  • Figure 5
    Figure 5

    Posteroanterior chest radiograph of a 19-year-old patient with mediastinal emphysema and subcutaneous emphysema.

    Reprinted from CXRs in Cardiovascular Disease, copyright 2023 by RYC, LLC; used with permission of RYP, LLC, all rights reserved.

  • Figure 6
    Figure 6

    Lateral chest radiograph of same 19-year-old patient showing anterior pneumomediastinum.

    Reprinted from CXRs in Cardiovascular Disease, copyright 2023 by RYC, LLC; used with permission of RYP, LLC, all rights reserved.

  • Figure 7
    Figure 7

    Anteroposterior chest radiograph of a female patient with pneumopericardium that demonstrates the same pericardial disease as that of the patient presented in Case 3. Because of pneumopericardium, the normal pericardium is less than 2 mm in thickness and the superior reflections of the parietal pericardium are within 2 to 3 cm from where the ascending aorta leaves and the superior vena cava enters the heart.

    Reprinted from CXRs in Cardiovascular Disease, copyright 2023 by RYC, LLC; used with permission of RYP, LLC, all rights reserved.

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