This 58-yr old patients had pericardial effusion on echodardiography. After evacuation of bloody pericardial effusion by pericardiocentesis, his symptoms were subsided. After then, he uneventfully convalesced. On the 32th day, sudden dyspnea developed with narrow pulse pressure. So exploratory pericardiotomy was done under the impression of cardiac tamponade.

At operation, we noticed diffuse hemangiomatous lesion at epicardium and large amount of bloody pericardial effusion. We performed only diagnostic excisional biopsy because the lesion was too extensive and location was not suitable for total excision. The lesion was confirmed to be pericardial hemangioma histologically.