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Azygos reflux: a CT sign of cardiac tamponade

S R Harries1, B M Fox, C A Roobottom

  • 1Department of Radiology, Derriford Hospital, Plymouth, Devon, UK.

Clinical Radiology
|October 10, 1998
PubMed

Insights

Dynamic contrast-enhanced computed tomography (CT) revealed contrast reflux into the azygos vein in patients with pericardial effusion. This finding suggests cardiac tamponade, a serious condition impacting hemodynamics.

Area of Science:

  • Radiology
  • Cardiology
  • Medical Imaging

Background:

  • Pericardial effusions can be challenging to diagnose clinically.
  • Dynamic contrast-enhanced computed tomography (CT) is a key imaging modality for thoracic assessment.

Observation:

  • Three patients presented with pericardial effusions and contrast reflux into the azygos vein during thoracic CT.
  • This specific CT finding was not observed in 30 control scans using a similar protocol.

Findings:

  • Azygos vein contrast reflux in the presence of pericardial effusion is a CT sign suggestive of cardiac tamponade.
  • Clinical diagnosis of cardiac tamponade was not initially made in these cases.
  • Diagnosis was confirmed via echocardiography or post-mortem examination.

Implications:

  • Azygos vein contrast reflux indicates significant hemodynamic compromise.
  • This CT finding can aid in the early diagnosis of cardiac tamponade.
  • Prompt diagnosis and intervention are crucial for patient outcomes.

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