scholarly journals Giant Pericardial Lipoma Inducing Cardiac Tamponade and New Onset Atrial Flutter

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Connor Charles Kerndt ◽  
Alexander Michael Balinski ◽  
Hayk Vahe Papukhyan

Although pericardial lipomas are both rare and benign, rapid or excessive growth can induce potentially fatal conditions such as pericarditis, arrhythmia, and cardiac tamponade. This case illustrates an example where a 65-year-old with atypical chest tightness unveiled a 10×15 cm anterior pericardial mass with circumferential effusion and progressive deterioration to cardiac tamponade. Initial transthoracic echocardiogram imaging was technically difficult in this patient due to habitus and body mass, which failed to illustrate underlying effusion. Recurrent bouts of refractory supraventricular tachycardia prompted further investigation of this patient’s presentation with transesophageal echocardiogram, which showed evidence of an echogenic mass with cardiac tamponade. An urgent pericardial window and pericardial lipectomy immediately relieved this hemodynamically compromising condition. Subsequent atrial flutter resulted with the removal of the anterior fat pad during surgery, complicating recovery.

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094589 ◽  
Author(s):  
Jia-Wan Wang ◽  
Ying-Qi Chen

Cardiac tamponade is a rare complication that occurs during hemihepatectomy. This particular complication has a high degree of mortality and morbidity. A 51-year-old woman was admitted to our hospital for surgical treatment of a malignant liver tumor. During surgery, she developed sudden hemodynamic instability and signs suggesting cardiac tamponade, which was confirmed via transthoracic echocardiogram. Cardiac compression and creation of a pericardial window resulted in immediate hemodynamic improvement. At completion of surgery, a repeated transthoracic echocardiogram showed no pericardial effusion. Early ultrasound-assisted diagnosis and treatment of cardiac tamponade are crucial. Although cardiac tamponade rarely occurs during hemihepatectomy, medics should be aware of this possibility to ensure prompt diagnosis. Our findings strongly support the use of early cardiac compression in cardiac arrest during surgery with echocardiography for prompt and accurate diagnosis of cardiac tamponade. Additionally, our findings will hopefully make anesthesiologists aware of the need to maintain a high index of suspicion for cardiac tamponade with sudden hypotension and a large reduction in differential pressure, and encourage early use of echocardiography and timely cardiac compression.


2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Christina Walker ◽  
Vincent Peyko ◽  
Charles Farrell ◽  
Jeanine Awad-Spirtos ◽  
Matthew Adamo ◽  
...  

Abstract Background This case report demonstrates pericardial effusion, acute pericarditis, and cardiac tamponade in an otherwise healthy woman who had a positive test result for coronavirus disease 2019. Few case reports have been documented on patients with this presentation, and it is important to share novel presentations of the disease as they are discovered. Case presentation A Caucasian patient with coronavirus disease 2019 returned to the emergency department of our hospital 2 days after her initial visit with worsening chest pain and shortness of breath. Imaging revealed new pericardial effusion since the previous visit. The patient became hypotensive, was taken for pericardial window for cardiac tamponade with a drain placed, and was treated for acute pericarditis. Conclusion Much is still unknown about the implications of coronavirus disease 2019. With the novel coronavirus disease 2019 pandemic, research is still in process, and we are slowly learning about new signs and symptoms of the disease. This case report documents a lesser-known presentation of a patient with coronavirus disease 2019 and will help to further understanding of a rare presentation.


2021 ◽  
Author(s):  
Teerapat Nantsupawat ◽  
Venkatakrishna N. Tholakanahalli ◽  
Yanhui Li ◽  
Stephanie Li ◽  
Neeraj Sathnur ◽  
...  

2018 ◽  
Vol 121 (9) ◽  
pp. 1072-1075 ◽  
Author(s):  
Andrew J. Foy ◽  
John Mandrola ◽  
Guodong Liu ◽  
Gerald V. Naccarelli

Author(s):  
Allan Klein ◽  
Paul Cremer ◽  
Apostolos Kontzias ◽  
Muhammad Furqan ◽  
Ryan Tubman ◽  
...  

Background Patients with recurrent pericarditis (RP) may develop complications, multiple recurrences, or inadequate treatment response. This study aimed to characterize disease burden and unmet needs in RP. Methods and Results This retrospective US database analysis included newly diagnosed patients with RP with ≥24 months of continuous history following their first pericarditis episode. RP was defined as ≥2 pericarditis episodes ≥28 days apart. Some patients had ≥2 recurrences, while others had a single recurrence with a serious complication, ie, constrictive pericarditis, cardiac tamponade, or a large pericardial effusion with pericardiocentesis/pericardial window. Among these patients with multiple recurrences and/or complications, some had features relating to treatment history, including long‐term corticosteroid use (corticosteroids started within 30 days of flare, continuing ≥90 consecutive days) or inadequate treatment response (pericarditis recurring despite corticosteroids and/or colchicine, or other drugs [excluding NSAIDs] within 30 days of flare, or prior pericardiectomy). Patients (N=2096) had hypertension (60%), cardiomegaly (9%), congestive heart failure (17%), atrial fibrillation (16%), autoimmune diseases (18%), diabetes mellitus (21%), renal disease (20%), anxiety (21%), and depression (14%). Complications included pericardial effusion (50%), cardiac tamponade (9%), and constrictive pericarditis (4%). Pharmacotherapy included colchicine (51%), NSAIDs (40%), and corticosteroids (30%), often in combination. This study estimates 37 000 US patients with RP; incidence was 6.0/100 000/year (95% CI, 5.6‒6.3), and prevalence was 11.2/100 000 (95% CI, 10.6‒11.7). Conclusions Patients with RP may have multiple recurrences and/or complications, often because of inadequate treatment response and persistent underlying disease. Corticosteroid use is frequent despite known side‐effect risks, potentially exacerbated by prevalent comorbidities. Substantial clinical burden and lack of effective treatments underscore the high unmet need.


2015 ◽  
Vol 33 (3) ◽  
pp. 146-149 ◽  
Author(s):  
Taha A. Faruqi ◽  
Usama A. Hanhan ◽  
James P. Orlowski ◽  
Katie S. Laun ◽  
Andrew L. Williams ◽  
...  

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