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Updated: Oct 17, 2025

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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A High-Echoic Layer Surrounding the Heart Suggesting Cardiac Tamponade by Clotting

Ikuto Takeuchi1, Jun Shitara1, Youichi Yanagawa1

  • 1Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Shizuoka Prefecture, Japan.

Aorta (Stamford, Conn.)
|October 12, 2021
PubMed

Insights

Sudden cardiac arrest in a teen was linked to high-echoic clotting cardiac tamponade. Prompt diagnosis and intervention are crucial for managing this critical condition.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Diagnostic Imaging

Background:

  • Cardiac tamponade is a life-threatening condition caused by fluid accumulation around the heart.
  • Clotting cardiac tamponade, particularly with high-echoic findings, presents diagnostic challenges.

Purpose of the Study:

  • To highlight the importance of recognizing high-echoic findings in diagnosing clotting cardiac tamponade.
  • To emphasize the critical nature of timely intervention in such cases.

Main Methods:

  • Case report of a 16-year-old male presenting with sudden loss of consciousness and cardiac arrest.
  • Diagnostic ultrasound revealing a high-echoic layer surrounding the heart.
  • Urgent surgical intervention via thoracotomy with pericardiotomy.

Main Results:

  • The patient presented with cardiac arrest and was diagnosed with clotting cardiac tamponade.
  • Despite urgent surgical intervention, return of spontaneous circulation was not achieved.
  • Ultrasound findings indicated a significant high-echoic pericardial effusion.

Conclusions:

  • High-echoic areas on ultrasound are critical indicators of clotting cardiac tamponade.
  • Accurate and rapid diagnosis is essential for potentially improving outcomes in this emergent condition.
  • Physician awareness must extend beyond low-echoic findings to include high-echoic presentations of cardiac tamponade.

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