Echocardiographic findings in a patient with tamponade due to anterior mediastinal hematoma.

A patient with blunt trauma to the sternum had clinical evidence of cardiac tamponade and echocardiographic findings highly suggestive of pericardial effusion. Bloody fluid was obtained by precordial pericardiocentesis. With the clinical diagnosis of pericardial tamponade, operation showed a large anterior mediastinal hematoma. In patients with anterior mediastinal hematoma, echocardiography could be misleading, and if pericardiocentesis is needed it should be done via a subxyphoid approach to help differentiate between these two entities.