Intrapericardial tetracycline sclerosis in the treatment of malignant pericardial effusion: an analysis of thirty-three cases.

Thirty-three unselected patients with cardiac tamponade secondary to malignant pericardial effusion were treated by intrapericardial instillation of tetracycline hydrochloride. Complete control of the initial signs and symptoms of tamponade was obtained in 30 patients without concomitant chemotherapy or radiotherapy. The procedure did not result in clinically significant complications. Failure of the technique was related to premature removal of the catheter by the patient (one patient) or the inability to totally remove hemorrhagic, clot-filled pericardial fluid (two patients). Survival ranged between 28-704 days and extended survival was related to the performance status and/or chemoradiosensitivity of the primary cancer. No patient successfully treated subsequently developed recurrent cardiac tamponade or alternatively, constrictive pericarditis. Tetracycline pericardial instillation remains a safe, simple, and efficacious treatment of tamponade secondary to malignant disease.

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Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

SAGE Open Medical Case Reports ◽

10.1177/2050313x211036005 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110360

Author(s):

Lardinois Benjamin ◽

Goeminne Jean-Charles ◽

Miller Laurence ◽

Randazzo Adrien ◽

Laurent Terry ◽

...

Keyword(s):

Pericardial Effusion ◽

Cardiac Tamponade ◽

Cardiac Toxicity ◽

Checkpoint Inhibitors ◽

Final Diagnosis ◽

Pericardial Fluid ◽

Malignant Pericardial Effusion ◽

Typical Cell ◽

High Fluorescence ◽

Tomography Scan

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.

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Cardiac tamponade due to malignant pericardial effusion in breast cancer: A case report

Bangabandhu Sheikh Mujib Medical University Journal ◽

10.3329/bsmmuj.v9i1.28946 ◽

2016 ◽

Vol 9 (1) ◽

pp. 53

Author(s):

Sultan Mahmud ◽

Omar Sadeque Khan ◽

Md. Aftabuddin ◽

Asit Baran Adhikary

Keyword(s):

Breast Cancer ◽

Pericardial Effusion ◽

Cardiac Tamponade ◽

Duct Cell ◽

Pericardial Fluid ◽

Pericardial Window ◽

Severe Respiratory Distress ◽

Malignant Pericardial Effusion ◽

History Of ◽

Subxiphoid Pericardial Window

We present a case of 35 years old women who presented to our institution with a history of bilateral infiltrating duct cell carcinoma of breast, chest pain with heaviness, severe respiratory distress and hypotension. Echocardiography revealed massive pericardial effusion with features of cardiac tamponade. The patient was treated with urgent pericardiocentesis followed by subxiphoid pericardial window drainage of 500ml of haemorrhagic pericardial fluid. Cytological examination confirmed the previous suspicious of malignancy. The patient tolerated the procedure very well, immediate symptomatic relief was observed.

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

Journal of Medical Case Reports ◽

10.1186/s13256-020-02467-w ◽

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.

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Unsuspected Malignant Pericardial Effusion Causing Cardiac Tamponade

CHEST Journal ◽

10.1378/chest.82.4.501 ◽

1982 ◽

Vol 82 (4) ◽

pp. 501-503 ◽

Cited By ~ 13

Author(s):

Frank E. Johnson ◽

Michael K. Wolverson ◽

Murali Sundaram ◽

Elisabeth Heiberg

Keyword(s):

Pericardial Effusion ◽

Cardiac Tamponade ◽

Malignant Pericardial Effusion

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Survival After Malignant Pericardial Effusion and Cardiac Tamponade in Advanced Ovarian Cancer

Southern Medical Journal ◽

10.1097/00007611-199002000-00028 ◽

1990 ◽

Vol 83 (2) ◽

pp. 241-242 ◽

Cited By ~ 9

Author(s):

ZOHAR LEVITAN ◽

ALAN L. KAPLAN ◽

ALAN N. GORDON

Keyword(s):

Ovarian Cancer ◽

Pericardial Effusion ◽

Cardiac Tamponade ◽

Advanced Ovarian Cancer ◽

Malignant Pericardial Effusion

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Graves’ disease inducing a massive cardiac tamponade

BMJ Case Reports ◽

10.1136/bcr-2020-239772 ◽

2021 ◽

Vol 14 (3) ◽

pp. e239772

Author(s):

Elisabeth Martinez Fonseca ◽

Igor Schonhofen ◽

Maria Pereira Toralles ◽

Jozelio Freire de Carvalho

Keyword(s):

Pericardial Effusion ◽

Cardiac Tamponade ◽

Nyha Class ◽

Clinical Manifestations ◽

Emergency Admission ◽

Heart Association ◽

Pericardial Fluid ◽

Graves Disease ◽

Class Iii ◽

Filling Time

A 23-year-old woman was diagnosed with Graves’ disease 5 months ago with decompensated thyroid function, for which she is taking thiamazole and propranolol. She developed progressive respiratory dyspnoea [New York Heart Association (NYHA) class III] and frequent palpitations. On emergency admission, the patient was tachypnoeic, hypotensive (77/54 mm Hg) and tachycardic (120 beats per minute), with an oxygen saturation of 94%. She also presented with cold, swollen and shaky extremities, with extended capillary filling time, and a significant reduction in heart sounds. Echocardiogram showed massive pericardial effusion compatible with cardiac tamponade. Pericardiocentesis was performed, with a drainage of 1420 mL serosanguinolent fluid, with prompt haemodynamic recovery. Analysis of the pericardial fluid showed exudates. A diagnosis of pericardial effusion secondary to Graves’ disease was determined and corticotherapy, lithium carbonate, cholestyramine and phenobarbital were prescribed. An oral iodine-131 was performed and the patient showed reasonable control of the clinical manifestations of hyperthyroidism. After 3 months, the patient showed no symptoms of hyperthyroidism and a new echocardiogram revealed a significant reduction in pericardial effusion.

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