A red blanket above the heart

Abstract

In surgical practice, the evolution of a hemopericardium beyond its acute phase is infrequent, especially when most of these conditions have a traumatic cause. In one way or another, the clinic usually triggers two antagonistic events: the patient dies due to cardiac tamponade or is treated satisfactorily, by pericardiocentesis or thoracotomy with limited access to the middle mediastinum. In any case, once access to the pericardial space is achieved and the heart is examined, there is practically no remaining evidence on its surface –except perhaps the obvious hematoma found on Morgagni's table– due to recent accumulation of blood inside. For these reasons, it is rare to observe –literally– in all its splendor the repercussion of a «chronic» hemopericardium on the heart of a living individual. The image presented shows the deposition and, presumably, the subsequent impregnation of red blood cells contained in a pericardial effusion, on the epicardium of a patient with possible tumor metastasis.