Figure 1.

Viral Hemorrhagic Pericardial Effusion With Cardiac Tamponade

(A) Transthoracic echocardiographic apical 4-chamber view with separation of pericardial layers of 28 mm. (B) Respiratory variation in transmitral flow of 25%. (C and D) Hematoxylin and eosin–stained sections of the pericardium tissue sample. (C) Capillary congestion and wall infiltration of polymorphonuclear leukocytes (original magnification ×40). (D) Incipient periarteriolar fibrinoid necrosis and leukocyte infiltrate (original magnification ×40). (E and F) Electron microscopy of the pericardium ultrastructure. (E) Viral particles (arrowhead) are shown in a blood vessel (original magnification ×50,000). (F) Viral particles (arrowhead) are shown in the interstitium of a vessel and an epithelial cell (original magnification ×50,000).