Echocardiographic images in unusual hemorrhagic pericarditis.

Two children with acute symptomatic pericardial effusion had unusual echocardiographic findings. In each case, the pericardial effusion was hemorrhagic. Echocardiography displayed numerous linear bands coursing across the pericardial space. Recognition of this characteristic image may predict that an acute effusion is loculated, and perhaps hemorrhagic, so that surgical drainage will offer the most definitive treatment. Knowledge gained during management of the first patient was used to anticipate treatment of the second patient, influencing the choice to perform pericardiocentesis in the catheterization laboratory and to alert surgical colleagues of the anticipated need for surgical drainage.