CT for evaluation of acute pericardial emergencies in the ED

Acute pericardial emergencies may present with acute chest pain. Although complete diagnosis and physiological effects of acute pericardial disease may require a combination of different imaging, CT plays a critical role in identifying the cause of chest pain in the ED. Many of these pericardial diseases can be fatal unless emergent treatment is obtained. The presentation can often be non-specific and symptoms can be overlapping with other diseases originating in the thorax or abdomen. Optimizing the CT scan is imperative when acute pericardial disease is suspected from clinical examination or preliminary imaging. The interpreting radiologist needs to be aware of the different entities which represent acute pericardial emergencies requiring urgent therapeutic intervention. Time is the essence, the clock is ticking, and every minute counts!