Pericardial Disease and Cardiac Tumors

2016 ◽  
pp. 103-106
Author(s):  
Kyle W. Klarich
Keyword(s):  
Chest Pain ◽  
Cardiac Tumors ◽  
Low Grade ◽  
Clear Fluid ◽  
Pericardial Disease ◽  
Parietal Pericardium ◽  
Cardiac Displacement

The space between the visceral and parietal pericardium normally contains 15 to 25 mL of clear fluid. The pericardium functions to prevent cardiac distention, limit cardiac displacement (by its attachment to neighboring structures), and protect the heart from inflammation. The chest pain of pericarditis is aggravated by movement of the trunk, inspiration, and coughing. The pain can be relieved by sitting up. Low-grade fever and malaise may occur.

Diseases of the Pericardium, Cardiac Tumors, and Cardiac Trauma

2016 ◽  
Author(s):  
Terrence D. Welch ◽  
Kyle W Klarich ◽  
Jae K. Oh
Keyword(s):  
Pericardial Effusion ◽  
Constrictive Pericarditis ◽  
Restrictive Cardiomyopathy ◽  
Left Ventricular ◽  
Cardiac Tumors ◽  
Management Options ◽  
Acute Pericarditis ◽  
Pericardial Disease ◽  
Cardiac Trauma ◽  
Pulsed Wave Doppler

The pericardium consists of a fibrous sac and a serous membrane. Because of its simple structure, the clinical syndromes involving the pericardium are relatively few but vary substantially in severity. Cardiac tumors may be either primary or secondary and either benign or malignant, with attachment sites throughout the endocardium. Cardiovascular trauma should be suspected in all patients with chest injuries or severe generalized trauma. Cardiovascular injury may be either blunt or penetrating. This review covers pericardial disease, cardiac tumors, and cardiovascular trauma. Figures show an electrocardiogram in acute pericarditis; acute pericarditis with delayed gadolinium enhancement of the pericardium shown with cardiac magnetic resonance imaging; underlying cause of pericardial effusion requiring pericardiocentesis; pericardial pressure-volume curves; large pericardial effusion with swinging motion of the heart resulting in electrical alternans; typical pulsed-wave Doppler pattern of tamponade; underlying causes of constrictive pericarditis in patients undergoing pericardiectomy; pericardial calcification seen on a chest radiograph; thickened pericardium; typical pulsed-wave Doppler pattern of constrictive pericarditis; typical mitral annular tissue velocities in constrictive pericarditis; a diagnostic algorithm for the echocardiographic diagnosis of constrictive pericarditis; simultaneous right ventricular and left ventricular pressure tracings in restrictive cardiomyopathy; computed tomographic scan showing inflammatory constrictive pericarditis; systolic and diastolic transesophageal echocardiographic images of a large left atrial myxoma attached to the atrial septum; a decision tree of management options for patients with suspected papillary; transesophageal echocardiographic examples of aortic valve, mitral valve, left ventricular outflow tract, and tricuspid valve papillary fibroelastomas; and transesophageal short-axis view of the descending thoracic aorta in a hypotensive patient after a motor vehicle accident. The table lists tamponade versus constriction versus restrictive cardiomyopathy. This review contains 18 highly rendered figures, 1 table, and 77 references.

scholarly journals A Physiotherapeutic Approach Along with Bronchodilators to Control Bronchial Asthma in a 35 Year Old Adult: A Case Report

2021 ◽  
pp. 121-125
Author(s):  
Nupur Thombare ◽  
Madhumita Yadav ◽  
Pratik Phansopkar
Keyword(s):  
Chest Pain ◽  
Bronchial Asthma ◽  
Past History ◽  
Common Disease ◽  
Low Grade ◽  
It Use ◽  
Postural Drainage ◽  
Old Adult ◽  
Night Sweats ◽  
History Of

Background: Bronchial asthma is a common disease characterized by the generalized narrowing of intrapulmonary airways accompanied by breathlessness and wheezing, which differs in severity spontaneously or as a result of treatment. Asthma is caused by bronchial wall inflammation and constriction due to the hyper-reactivity of their smooth muscle, resulting in a series of spasmodic wheezing attacks and shortness of breath (SOB). Case description: The patient was a 35 year old female presented with a complaint of dry cough with mucoid expectoration and chest pain since 3 weeks. The cough was progressive and aggravating while walking or while doing any sort of activity and it use to relieve at rest. She also complained of Modified Medical Research Council (MMRC) grade 2 breathlessness along with palpitation while doing household work. She had chest pain while coughing on left side over the 2nd intercostal space which was gradually progressive and 7/10 on VAS. She also had low grade fever, cold with chills and night sweats. The patient had a history of seasonal variation, dust allergies and biomass exposure. She was given medications but was not relieved so she was referred for physiotherapy. Physiotherapy treatment was started. Patients sleep was disturbed. The patient had no past history. Family history is not present. Diagnosis: The patient was diagnosed with bronchial asthma. Outcomes & conclusion: This case study showed that breathing exercise, postural drainage and proper relaxation of the patient may reduce the symptoms associated with bronchial asthma also the peak flow values may increase with breathing retraining. Pain reduces with reduction in cough and episodes of dyspnoea. Also educating the patient about prevention of asthmatic episodes help the patient in many ways. Along with bronchodilators physiotherapy plays an integral part in treating the patient with bronchial asthma.

Diseases of the Pericardium, Cardiac Tumors, and Cardiac Trauma

2019 ◽  
Author(s):  
Terrence D. Welch ◽  
Salima Shafi ◽  
Jae K. Oh
Keyword(s):  
Key Words ◽  
Cardiac Tumors ◽  
Thoracic Cavity ◽  
Fibrous Layer ◽  
Cardiac Trauma ◽  
Pericardial Cavity ◽  
Stable Position ◽  
Parietal Pericardium ◽  
Large Vessels ◽  
Serous Layer

The pericardium consists of an outer fibrous layer and an inner serous layer. The serous layer covers the surface of the heart and the proximal portion of the large vessels (visceral pericardium), folds back on itself, and lines the fibrous layer (parietal pericardium). Normal pericardial thickness is less than or equal to 2 mm. The space between the visceral and the parietal layer forms the pericardial cavity, which normally contains 10 to 50 mL of fluid. The pericardium lubricates and reduces friction, serves as a barrier against infection, maintains the heart in a relatively stable position within the thoracic cavity, and prevents acute distention of the cardiac chambers. None of these functions, however, is essential for life, and the pericardium may, in fact, be absent at birth. This review contains 16 figures, 1 table, and 50 references. Key Words: Pericardium, parietal pericardium, visceral pericardium

Bevacizumab Therapy for POEMS Syndrome.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5108-5108
Author(s):  
Karthik Ramasamy ◽  
Stephen Lang ◽  
Jackie Chapell ◽  
Stephen Schey
Keyword(s):  
Clinical Response ◽  
Ascitic Fluid ◽  
Bowel Perforation ◽  
Performance Status ◽  
Poems Syndrome ◽  
Lower Limbs ◽  
Low Grade ◽  
Clear Fluid ◽  
Fourth Dose ◽  
Vegf Level

Abstract 41 yr old male presented with pain and weakness of upper and lower limbs. He was bed bound with ECOG score 4. Investigations confirmed the diagnosis of POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, skin changes) syndrome. He had typical features including glomerular hemangiomas on the skin, mild hepatosplenomegaly, sensorimotor polyneuropathy, IgG lambda paraprotein 3.3g/l, elevated FSH, LH and TSH. A course of cyclophosphamide and dexamethasone was given with no clinical response. He was also given a trial of plasma exchange and parenteral Immunoglobulins. Symptoms plateaued and he was followed up with rehabilitation support. He re-presented 18 months later with widespread low-grade lymphadenopathy, stable paraprotein, ascites, poor appetite and weight loss. Lymph node biopsy showed Castleman’s disease like changes along with osteosclerotic lesions in pelvis and raised CSF protein of 3.13g/l with rest of CSF analysis being normal. Bone marrow trephine showed paratrabecular deposits of lambda light chain restricted CD38 positive plasma cells. Ascitic fluid was sterile consistent with a transudate. Vascular endothelial growth factor (VEGF) level prior to treatment was elevated at 4587 pg/ml (Normal: 72–704 pg/ml). Large volume abdominal paracentesis ranging between 2–3 litres of clear fluid was performed weekly. In view of the raised VEGF, 4 doses of Bevacizumab (anti-VEGF) 2.5mg/kg were administered as an intravenous infusion over one hour fortnightly. VEGF level normalised after first dose of bevacizumab (131.2 pg/ml) and remained normal prior to the fourth dose (136.5 pg/ml). There were no infusional reactions or haematologic adverse effects. Frequency of paracentesis decreased to three weekly, his appetite and performance status improved with ECOG score 2. 3 weeks after the fourth dose he was readmitted with tense ascites, pleural effusion, diarrhoea, pyrexia and severe abdominal pain. Meropenem resistant pseudomonas was grown from ascitic fluid. After therapeutic paracentesis and antibiotics a Leveen shunt from abdomen to right internal jugular vein was performed to prevent reaccumulation. Despite shunting, he reaccumulated fluid in the third space and developed respiratory and pre renal failure and succumbed to it. At post mortem there were non-specific changes in the lungs and heart with no evidence of pulmonary embolism or bowel perforation and Leveen shunt remained patent. Bevacizumab promptly reduced VEGF levels with significant reduction in pleural and peripheral effusion with subjective improvement in neurological status. Bevacizumab appears to induce clinical response in a proportion of patients with POEMS syndrome. We suggest that a Phase I study should be considered to identify dose, duration of therapy and safety of Bevacizumab.

scholarly journals EXERTIONAL CHEST PAIN AND DYSPNEA SECONDARY TO EPICARDIAL LOW-GRADE B CELL LYMPHOMA

2014 ◽  
Vol 63 (12) ◽  
pp. A631
Author(s):  
Eric R. Fenstad ◽  
John Stulak ◽  
H.S. Abu-Lebdeh ◽  
Phillip J. Young ◽  
William Freeman
Keyword(s):  
Chest Pain ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Low Grade

scholarly journals Cardiac masses due to tumors (diagnosis, clinical manifestations and surgical treatment)

2014 ◽  
Vol 95 (6) ◽  
pp. 806-810 ◽  
Author(s):  
D L Kranin
Keyword(s):  
Surgical Treatment ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Surgical Excision ◽  
Benign Tumors ◽  
Cardiac Tumors ◽  
Low Grade ◽  
Imaging Results ◽  
Valvular Heart Diseases ◽  
Cardiac Myxomas

Aim. To summarize the experience on the diagnosis and surgical treatment of primary benign and malignant cardiac tumors. Methods. The paper describes 37 clinical observations of endocavitary primary benign and malignant cardiac tumors: 26 (70.3%) cases of cardiac myxoma, 5 (13.5%) - rhabdomyosarcoma, 2 (5.4%) - angiosarcoma, 1 (2.7% ) - leiomyosarcoma, 1 (2.7%) - fibrosarcoma, 1 (2.7%) - liposarcoma. Patients were 15 (40.5%) males and 22 (59.5%) females aged 18 to 65 years. Endocavitary cardiac tumors were diagnosed by noninvasive tests: echocardiography, computed tomography, magnetic resonance imaging. Results. Patients with primary benign and malignant cardiac tumors had variable clinical manifestations. Symptoms of astenoneurotic syndrome, auscultatory and cardiophonographic signs simulating acquired or congenital valvular heart diseases, which often have a positional relationship; low-grade fever of unknown origin, weight loss were registered. Paraneoplastic syndrome was characterized by an increase in erythrocyte sedimentation rate, leukocytosis, monocytosis, dysproteinemia, polycythemia, hypochromic anemia, increased levels of C-reactive protein. Surgical excision of 25 cardiac myxomas and 8 malignant tumors of the heart was performed with cardiopulmonary bypass, pharmacological cardioplegia and general hypothermia. In 1 case the tumor resection was combined with coronary artery bypass grafting. In 3 patients suffering from malignant tumors, explorative thoracotomy was performed. Surgical revision, emergency and planned microscopic studies of removed cardiac tumors allowed to establish the final clinical diagnosis. Hospital mortality among patients operated for cardiac myxomas was 4.0%, for cardiac malignant tumors - 27.3%. Conclusion. Timely surgical treatment of patients with primary cardiac benign tumors (myxomas) leads to recovery and is accompanied by a relatively low mortality; better results of patients with cardiac endocavitary tumors treatment depend on the early detection and timely radical surgical excision.

Pericardial Disease

2014 ◽  
pp. 843-850
Author(s):  
Leonard S. Lilly
Keyword(s):  
Cardiac Tamponade ◽  
Constrictive Pericarditis ◽  
External Surface ◽  
Pericardial Fluid ◽  
Great Vessel ◽  
Acute Pericarditis ◽  
Inner Membrane ◽  
Pericardial Disease ◽  
Parietal Pericardium

The pericardium is a two-layered sac that surrounds the heart. It is composed of an outer stiff fibrous coat (the parietal pericardium) and a thin inner membrane that is adherent to the external surface of the heart (the visceral pericardium). The visceral pericardium reflects back at the level of the great vessel origins to form the inner lining of the parietal layer. The space between these two layers normally contains 15–50 mL of serous pericardial fluid, which permits the heart to contract in a minimum-friction environment. The major diseases of the pericardium are acute pericarditis, cardiac tamponade, and constrictive pericarditis.

Diseases of the Pericardium, Cardiac Tumors, and Cardiac Trauma

2019 ◽  
Author(s):  
Terrence D. Welch ◽  
Salima Shafi ◽  
Jae K. Oh
Keyword(s):  
Key Words ◽  
Cardiac Tumors ◽  
Thoracic Cavity ◽  
Fibrous Layer ◽  
Cardiac Trauma ◽  
Pericardial Cavity ◽  
Stable Position ◽  
Parietal Pericardium ◽  
Large Vessels ◽  
Serous Layer

The pericardium consists of an outer fibrous layer and an inner serous layer. The serous layer covers the surface of the heart and the proximal portion of the large vessels (visceral pericardium), folds back on itself, and lines the fibrous layer (parietal pericardium). Normal pericardial thickness is less than or equal to 2 mm. The space between the visceral and the parietal layer forms the pericardial cavity, which normally contains 10 to 50 mL of fluid. The pericardium lubricates and reduces friction, serves as a barrier against infection, maintains the heart in a relatively stable position within the thoracic cavity, and prevents acute distention of the cardiac chambers. None of these functions, however, is essential for life, and the pericardium may, in fact, be absent at birth. This review contains 16 figures, 1 table, and 50 references. Key Words: Pericardium, parietal pericardium, visceral pericardium

Sign in / Sign up

Export Citation Format

Share Document