A 45-year-old male patient was involved in a motor vehicle accident at high speeds. The following subcostal view of the heart was obtained while performing an eFAST exam.
What is the most likely diagnosis?
A. Free fluid in the peritoneal cavity
B. Pleural effusion
C. Pericardial effusion with tamponade
The most likely diagnosis is pericardial effusion with tamponade.
Explanation
The subcostal view of the heart is obtained through the liver. We see evidence of pericardial effusion. The RV free wall is collapsed with RV cavity almost obliterated. RV free wall collapse during diastole is indicative of tamponade physiology. This is a life-threatening situation and would require urgent pericardiocentesis. Always correlate clinically. See labeled image below.
References
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