Computed tomography demonstrated a solid soft-tissue density in the right aspect of the pericardium, significantly compressing the right atrium, measuring 9.1 × 7.4 cm in diameter (Fig. 1). Transthoracic echocardiography showed a good systolic function, a well-functioning aortic valve prothesis and a mass compressing the right atrium (Video 1). The patient underwent transoesophageal echocardiography-guided video-assisted thoracoscopic surgery and the pathology revealed that it was a localised haematoma. The haematoma was successfully drained, and the patient’s symptoms resolved afterwards (Video 2).