In this Through the Lens case, we examine the death of a 65-year-old individual found in a secure home by their partner. Dr. Jamie Elifritz highlights how postmortem CT identified hemopericardium—blood within the pericardial sac—and how its hyperdense ring appearance suggested antemortem hemorrhage, likely related to myocardial rupture. This case illustrates how PMCT can clarify cause of death in cases that might otherwise undergo only external examination.
Case: 65-year-old found in secure home by partner. PMH of hypertension and diabetes.
Question: What is the diagnosis?
Diagnosis: Hemopericardium.
Blood is present in the pericardial space.
This case scenario may meet criteria for external examination at some offices. PMCT is diagnostic for hemopericardium. Furthermore, the hyperdense ring morphology of the hemopericardium—observed in this case—is significantly associated with antemortem hemorrhage, particularly in scenarios such as myocardial wall rupture following myocardial infarction. [1]
- Yamaguchi, R., et al., Fluid-Fluid Level and Pericardial Hyperdense Ring Appearance Findings on Unenhanced Postmortem CT Can Differentiate Between Postmortem and Antemortem Pericardial Hemorrhage. American Journal of Roentgenology, 2015. 205(6): p. W568-W577.
