The increasing proportion of elderly individuals globally presents challenges in healthcare. Computed tomography (CT) is a widely utilized radiological modality valued for its rapid acquisition capabilities and accessibility. CT interpretation in elderly patients might be complicated due to age-related physiological changes: decreased bone density, organ elasticity, and increased calcifications. These factors, along with comorbidities like cardiovascular disease, diabetes, and cognitive impairments, complicate CT interpretation. Elderly people are at increased risk of contrast-induced nephropathy due to reduced renal function. Metal fragments, such as pacemakers, coronary stents and stent-grafts, are additional artefacts during CT. Moreover, patient cooperation can be limited by conditions such as dementia or hearing loss, leading to issues with motion and positioning during scans.
Considering age-related changes and comorbidities, the solutions in CT scanning might be personalized and specific to the elderly CT protocols. Pre-CT preparation, including clear instructions and strategies for patients with cognitive impairments or physical limitations, is beneficial. Multidisciplinary collaboration among radiologists, geriatricians, and specialists enhances diagnostic accuracy and cooperation. Technological advancements reduce artefacts, enhance image quality, and lower radiation exposure. Educating medical staff on the needs of elderly patients ensures better comfort and care. Implementing complex solutions for optimizing CT imaging might improve the diagnostic outcomes and patient experience.

Pericardial effusion (PE) can occur in inflammatory and infectious diseases; postoperatively, in pulmonary arterial hypertension, renal failure, as well as in malignant diseases that can affect the pericardium and manifest as a paraneoplastic syndrome (1). On the other hand, the presence of blood in the pericardial cavity – hemopericardium – is more commonly seen in aortic dissection, cardiac rupture, trauma, or after invasive procedures (2) and less frequently in malignant cardiac tumors. The late diagnosis of content in the pericardial cavity, often due to the absence of specific symptoms, can lead to delayed detection and preclude radical treatment in the case of tumors or neoplastic heart lesions. However, early diagnosis and tumor resection can significantly improve patients' condition and allow for life-extending chemotherapy (3). This case highlights the critical importance of early detection in pericardial effusion. The purpose of presenting this clinical case is to increase awareness and alertness among family doctors, therapists, cardiologists, cardiothoracic surgeons, and radiologists to exclude neoplastic involvement of the heart when hydro- or hemopericardium is detected.