scholarly journals A Significant Pericardial Effusion Leading to Bronchial Compression: A Case Report

2021 ◽  
Vol 9 ◽  
pp. 232470962110050
Author(s):  
Suman Rao ◽  
Oluwateniola Olatunde ◽  
Akhila Sunkara ◽  
Vrinda Vyas ◽  
Andrew Weinberg
Keyword(s):  
Respiratory Failure ◽  
Pericardial Effusion ◽  
Left Lung ◽  
External Source ◽  
Pericardial Window ◽  
Pericardial Effusions ◽  
Left Main Stem Bronchus ◽  
Oxygen Requirements ◽  
Heart Contractility ◽  
Bronchial Compression

Commonly, pericardial effusions can cause suboptimal heart contractility. Larger pericardial effusions can lead to compression of structures that surround in the heart in the mediastinum. Our patient presented with dyspnea that required mechanical ventilation. Bronchoscopy revealed compression of the bronchus from an external source. Echocardiogram showed a large circumferential pericardial effusion, which compressed the left main stem bronchus causing left lung atelectasis and persistent respiratory failure. A subxiphoid pericardial window was performed, which led to an improvement in her oxygen requirements. This case portrays the importance of including pericardial effusions in patients who present with respiratory failure refractory to antibiotic treatment and intervention with bronchoscopy. Although our patient passed away, recognition and earlier appropriate management with a pericardial window or pericardiocentesis could have prevented this adverse event.

Resolution of a respiratory failure due to massive chronic pericardial effusion with a pericardial window: the simplest is the best

2017 ◽  
Vol 1 ◽  
pp. 1-1
Author(s):  
Barbara Bonfanti ◽  
Luca Bertolaccini ◽  
Piercamillo Pavesi ◽  
Eugenio Detotto ◽  
Stefano Parini ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Pericardial Effusion ◽  
Pericardial Window

The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

scholarly journals Pericardial effusion and cardiac tamponade requiring pericardial window in an otherwise healthy 30-year-old patient with COVID-19: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Christina Walker ◽  
Vincent Peyko ◽  
Charles Farrell ◽  
Jeanine Awad-Spirtos ◽  
Matthew Adamo ◽  
...  
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Case Reports ◽  
Healthy Woman ◽  
Signs And Symptoms ◽  
Rare Presentation ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Novel Coronavirus

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.

Video-thoracoscopic pericardial window in the diagnosis and treatment of pericardial effusions

1998 ◽  
Vol 82 (1) ◽  
pp. 124-A9 ◽  
Author(s):  
Patrick Nataf ◽  
P. Cacoub ◽  
Mary Regan ◽  
F. Baron ◽  
Richard Dorent ◽  
...  
Keyword(s):  
Diagnosis And Treatment ◽  
Pericardial Window ◽  
Pericardial Effusions

Video-Assisted Pericardial Fenestration for Effusions after Cardiac Surgery

2009 ◽  
Vol 17 (5) ◽  
pp. 480-482 ◽  
Author(s):  
Georgios P Georghiou ◽  
Eyal Porat ◽  
Avi Fuks ◽  
Bernardo A Vidne ◽  
Milton Saute
Keyword(s):  
Cardiac Surgery ◽  
Pericardial Effusion ◽  
Surgical Techniques ◽  
Lung Ventilation ◽  
Pericardial Window ◽  
Invasive Approach ◽  
Video Assisted ◽  
Institutional Experience ◽  
Pericardial Fenestration ◽  
Thoracoscopic Technique

Delayed-onset pericardial effusion following cardiac surgery can give rise to significant morbidity due to its presentation as well as management by traditional surgical techniques. An institutional experience of a video-assisted thoracoscopic technique to create a pericardial window, with the advantages of a minimally invasive approach combined with excellent visualization in such patients, was reviewed. A retrospective analysis was conducted on all patients undergoing video-assisted thoracoscopic for delayed pericardial effusion after cardiac surgery from January 2001 to January 2006 at our center. Seven patients with echocardiographically diagnosed delayed tamponade underwent video-assisted thoracoscopy; 5 were receiving anticoagulants after valve replacement, and 2 had undergone heart transplantation. Pericardial windows were created under general anesthesia and single-lung ventilation using 2 to 3 trocars. Mean operative time was 45 min. There were no complications of the thoracoscopic technique. Video-assisted thoracoscopic creation of a pericardial window is safe and effective treatment for loculated pericardial effusions secondary to cardiac surgery.

scholarly journals US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis

2021 ◽  
Author(s):  
Allan Klein ◽  
Paul Cremer ◽  
Apostolos Kontzias ◽  
Muhammad Furqan ◽  
Ryan Tubman ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Treatment Response ◽  
Constrictive Pericarditis ◽  
Unmet Need ◽  
Recurrent Pericarditis ◽  
Pericardial Window ◽  
Clinical Burden ◽  
Large Pericardial Effusion ◽  
Multiple Recurrences

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.

scholarly journals Capnocytophaga Induced Acute Necrotizing and Exudative Pericarditis with Abscess Formation

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Alexa Bello ◽  
Alejandro Castaneda ◽  
Abhay Vakil ◽  
Joseph Varon ◽  
Salim Surani
Keyword(s):  
Pulmonary Embolism ◽  
Pericardial Effusion ◽  
Broad Spectrum ◽  
Developed Countries ◽  
Abscess Formation ◽  
Pericardial Window ◽  
Acute Pericarditis ◽  
Large Pericardial Effusion ◽  
Acute Necrotizing ◽  
Pericardial Abscess

We present the case of a 55-year-old gentleman, with bilateral pulmonary embolism and a large pericardial effusion that lead to a pericardial window with evacuation of creamy pus. Gram stains were negative, with culture growing Capnocytophaga. Pathology revealed acute necrotizing and exudative changes, including frank abscess formation. In developed countries, pericardial abscess and acute pericarditis are uncommon due to availability of broad-spectrum antibiotics. Pericardial abscess due to Capnocytophaga is even more uncommon.

PULMONARY EMPHYSEMA AND OTHER CARDIORESPIRATORY LESIONS AS PART OF THE MARFAN ABIOTROPHY

PEDIATRICS ◽  
1964 ◽  
Vol 33 (3) ◽  
pp. 356-366
Author(s):  
Robert P. Bolande ◽  
Arthur S. Tucker
Keyword(s):  
Connective Tissue ◽  
Left Atrium ◽  
Pulmonary Emphysema ◽  
Left Lung ◽  
Left Main ◽  
Main Stem Bronchus ◽  
Giant Left Atrium ◽  
Left Main Stem Bronchus ◽  
The Right ◽  
Chronic Pulmonary Emphysema

Seven cases of Marfan's syndrome are reviewed clinically, radiologically, and pathologically. Six of the seven cases showed evidence of pulmonary dysaeration: (a) Two of the cases showed compression of the left main-stem bronchus by a giant left atrium with atelectasis of the left lung and compensatory emphysema of the right lung. (b) Two of the cases showed evidence of diffuse chronic pulmonary emphysema. Three cases had bilateral apical bullae. (c) One of the cases developed pneumothorax. The lungs of the children with the Marfan syndrome show precocious maturation of the elastic stroma of the alveolar septae. The pathogenesis of emphysema is discussed in relationship to the Marfan abiotrophy of connective tissue.

Abstract 17026: Pericardial Effusion in Children After Bone Marrow Transplant

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Niti Dham ◽  
Kelly Lyons ◽  
Blachy Davila Saldana
Keyword(s):  
Bone Marrow ◽  
Pericardial Effusion ◽  
Diastolic Function ◽  
Bone Marrow Transplant ◽  
Systolic Function ◽  
Pearson Correlation ◽  
Marrow Transplant ◽  
Pericardial Effusions ◽  
Z Scores ◽  
Life Threatening

Background: Bone marrow transplant (BMT) is necessary in varying diseases. However, it has known cardiac risks and complications, including pericardial effusions (PE). PE can be life threatening if not identified early, and its treatment can be invasive, ie pericardiocentesis. Our objective is to identify echocardiographic (echo) findings that could help identify high risk subsets for developing a PE post BMT. Methods: We retrospectively identified BMT patients from January 2011 - December 2019 in our institution that developed moderate to large PE requiring treatment. Our controls consisted of BMT patients that did not develop PE. Baseline demographics, BMT data, PE treatments, and echo data was obtained. Echo variables included markers of systolic function, diastolic function, and LV size prior to BMT in both sets of patients. We performed a t-test for comparison and Pearson correlation. Results: We performed over 180 BMTs in our institution during this time. Of these, 50 were noted to have any degree of pericardial effusion, but 15 patients developed symptomatic pericardial effusions requiring further interventions. Our study included 13 subjects and 12 controls. Our subjects ranged from 8 months to 17 years old, 3F/10M. Even though the left ventricle end diastolic diameter (LVIDd) z-scores were within normal, they were statistically larger (p 0.02) in the PE group. Both groups had the same average hemoglobin (9.2). There was no difference in the pre-BMT systolic function or diastolic function parameters between the two groups. The duration of the PE (after the BMT)correlated with LVIDd z-score (Figure 1; r 0.6, p 0.02) and MV septal E’ (r -0.6, p 0.03) and E/E’ (r 0.6, p 0.05) from the pre-BMT echo. Conclusions: Assessing LV size and LV diastolic markers pre-BMT could be simple yet important measurements to pay closer attention to, which can then help direct improved screening in pediatric post-BMT patients. These findings should be explored further in larger studies.

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