Air in the heart is a serious condition and may be life-threatening. It is usually of iatrogenic origin or the result of trauma. Computed tomography of a heart-lung transplant recipient who had unilateral hydropneumothorax revealed a mediastinal gas collection that appeared to be intracardiac. A follow-up study with intrapleural contrast medium revealed that the gas was not within but was actually between cardiac chambers. Consequently the gas collection mimicking intracardiac air was of no clinical importance.
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