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Massive cardiomegaly. Drainage catheter of a known pericardial effusion. Bilateral lung opacities.
Cardiac silhouette enlargement can be simply a result of supine AP projection. However, in this case the cardiac silhouette is massively enlarged, most commonly from cardiomegaly, however, a pericardial effusion was echographically diagnosed. Note the pericardial drainage catheter on the x-ray, which seems to drain insufficiently. The patient is at high risk for cardiac tamponade.