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THE PITFALLS IN INTERPRETING ARTIFICIAL PNEUMOPERICARDIUM

JAMES T. T. CHEN M.D., ROBERT H. PETER M.D., EDWARD J. ORGAIN M.D., and RICHARD G. LESTER M.D.

1. When the heart is surrounded by a blanket of air, it has considerably more freedom to expand and to move. Therefore, both the radiologist and the cardiologist must understand the altered dynamics and anatomy of the heart in order to avoid erroneous diagnosis and unnecessary surgery.

2. Fluoroscopy of the heart under image intensification is useful both for diagnosis of pericardial effusion and for evaluation of the pericardium and the heart following artificial pneumopericardium.

3. Emphasis is placed on the 3 "do nots:" (1) do not call a fluid wave within the pneumohydropericardium a tumor; (2) do not call the anterior nodularity of the heart in air implantation on the epicardium; and (3) do not call the nodular appearance of the left atrial appendage in pneumopericardium a tumor.


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