Concluded Case

central hiatus hernia.

75 yrs female presented with progressive dyspnea and non specific chest pain. HR 65/min BP 150/60mmhg. spo2 96% lab reports are not available. plz comment on cxray and suggest DDs.

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Concluded answer

Thanks all for your expert comments. Double heart borders mimiking pericardial effusion. It's a case of large ,central hiatus hernia.

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SUGGESTIVE OF CENTRAL HIATUS HERNIA.... MIMMICKING PERICARDIAL EFFUSION

Intresting case Mediastinum is widened Double cardiac borders are seen Shape 9f heart is bottle shape and likely pericardial effusion with hitus hernia Both cp angles are reduced and obscured

Thanx dr Sonali Mallik
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Thanks all for your expert comments. Double heart borders mimiking pericardial effusion. It's a case of large ,central hiatus hernia.

Nice case,sir!
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The water bottle sign or configuration refers to the shape of the cardiac silhouette on erect frontal chest x-rays in patients who have a very large pericardial effusion. Typically the effusion has accumulated over many weeks to months (e.g. in patients with malignancy) and the pericardium has gradually stretched.. Pericardial effusion can also occur when the flow of pericardial fluids is blocked or when blood accumulates within the pericardium, such as from a chest trauma. ... Causes of pericardial effusion can include: Inflammation of the pericardium following heart surgery or a heart attack.

Widening mediastinum, aortic knuckle enlarged and calcified, cardiomegaly, cardiovascular markings prominent bilateral costophrenic angle are obturated, pericardial effusion?to rule out further investigation needed.

Thanks all for your expert comments. Double cardiac borders. Mimiking, pericardial effusion. It's case of central hiatus hernia.

Enlarged cardiac silhouette Transverse diameter more than vertical Water bottle sign Suggestive of pericardial effusion

Characteristic Water bottle sign, suggestive of Pericardial effusion. 2D Echo to be done

Massive enlargement of cardiac shadow.pericardial effusion,dcmp.

Pericardial effusion Aspiration of effusion send for HPE

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