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Heart puncture-induced hemopericardium is a serious complication of the pericardiocentesis. Two-dimensional echocardiographic examination performed in two patients just before and after the development of hemopericardium revealed a unique image in which pericardial bleeding manifested itself by an echodensity thrombus appearance adjacent to the cardiac chambers. With appropriate differentiation to some other intrapericardial echodensity masses, such distinctive images can be highly specific for active bleeding into the pericardial sac.
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