title: A delayed diagnosis of cardiac tamponade.
abstract: A 64-year-old female was referred to the on-call surgical team by her general practitioner with a 2-week history of feeling generally unwell; more short of breath with lethargy and myalgia with a 2-day history of right upper quadrant abdominal pain. On initial assessment she was tachycardic and an abdominal examination revealed a soft abdomen with right upper quadrant tenderness. An abdominal ultrasound scan revealed a distended gall bladder with the diameter of the common bile duct at the upper limit of normal. It also revealed free fluid within the abdomen, bilateral pleural effusions and a large left ovarian cyst. The medical team became involved and ordered a CT thorax and abdomen which showed a large pericardial effusion, bilateral pleural effusions, a small amount of ascites and a large left ovary; reported as appearances most consistent with malignancy. On further assessment by a cardiologist the patient showed signs of cardiac tamponade and she underwent urgent pericardiocentesis.
authors.affiliation: Torbay Hospital, Torquay, UK. yaj@gmail.com
authors.forename: Abigail
authors.initials: A
authors.lastname: McGinley
authors.forename: Guy
authors.initials: G
authors.lastname: Gribbin
mesh_terms: D002305:Cardiac Tamponade / Q000000981:diagnostic imaging* / Q000601:surgery*; D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging* / Q000601:surgery*; D020519:Pericardiocentesis; D014057:Tomography, X-Ray Computed