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NewYork-Presbyterian Hospital Psychiatry
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Case of the Month - April 2018

This 57 year old man presented to Urgicare complaining of 3 days of cough, palpitations and fatigue.

Question 1 : What is the name and cause of the finding between the green arrows (and inside the blue circle) below?



View answer
Answer 1:

This is a called the “oreo cookie pericardial effusion sign.” The light/dark/light stripes (anterior to posterior) typically seen in this location on lateral chest x-ray are due to the epicardial fat pad, pericardial effusion and then pericardial fat pad. This patient ended up being admitted for new a-fib and his echo did confirm the presence a pericardial effusion (albeit small and not changing management.)

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