scholarly journals The Facilitation of Pericardiocentesis Using Imaging Techniques. A Case Report

2016 ◽  
Vol 2 (3) ◽  
pp. 129-133
Author(s):  
Ioan Manițiu ◽  
Iulia Cobârje ◽  
Ionuț Bitea ◽  
Radu Cojan ◽  
Andra-Maria Bebeşelea
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Bacterial Infections ◽  
Ultrasound Guidance ◽  
Imaging Techniques ◽  
Pericardial Fluid ◽  
Cardiac Ultrasound ◽  
Chest X Ray ◽  
Effusion Fluid

Abstract Introduction: Pericardiocentesis is a procedure performed for diagnostic and therapeutic purposes, and it consists in draining the pericardial effusion liquid in sterile conditions. The accumulation of fluid in the pericardial space may be caused by several systemic conditions, including viral or bacterial infections, autoimmune disease, cancer, as well as thyroid malfunction. A rapidly growing pericardial effusion can lead to cardiac tamponade, and consequently to acute hypodiastolic heart failure. Case report: We report the case of a 79-year-old female, without previously known cardiovascular pathologies, who presented to the Emergency Room due to a gradual deterioration in her health status. Imaging procedures included a chest X-ray and an echocardiography that confirmed the diagnosis of pericardial effusion. Pericardiocentesis was performed using cardiac ultrasound guidance, resulting in the draining of a small quantity of yellowish, partly haemorrhagic fluid. The patient's general condition did not improve, thus another pericardiocentesis was carried out, this time with fluoroscopical and cardiac ultrasound guidance, and 1200 milliliters of sero-haemorrhagic fluid was drained. The laboratory analysis revealed that the patient had hypothyroidism, and the cytological analysis of the drained pericardial fluid excluded a neoplastic origin, tuberculosis, and other infectious etiologies. The particularity of the case consists in a pericardial effusion evolving into cardiac tamponade, for which the pericardiocentesis was guided using echocardiographic, fluoroscopic and radiologic methods, because simple ultrasound-guided drainage was not efficient. Conclusion: The superiority of a combined imaging-guided approach in cases of pericardial effusion recommends it as an alternative to a surgical procedure, guided solely by echocardiography, which is often used in cases of unsuccessful drainage of pericar-dial effusion fluid.

Recurrent Episodes of Pericardial Effusion as Isolated Manifestation of Tuberculosis: Case Report

2018 ◽  
Vol 15 (1) ◽  
pp. 78-80
Author(s):  
Oscar Westin ◽  
Abbas Ali Qayyum
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Granulomatous Inflammation ◽  
Physical Contact ◽  
Tuberculosis Case ◽  
Chest X Ray ◽  
X Ray Computed ◽  
Polymerase Chain ◽  
Cytology Report ◽  
Biochemical Examination

Background: Recurrent episodes of isolated pericardial effusion due to tuberculosis, leading to reduced Left Ventricle Ejection Fraction (LVEF), are uncommon. Methods: This is a case report of a previously healthy 32-years old male with tuberculous induced pericardial effusion as isolated manifestation. The only known exposure of tuberculosis was a brother with whom the patient did not have physical contact during the last year. The pericardial effusion repeatedly appeared after being drained a total of three times. Due to recurrent episodes of pericardial effusion, severe thickening of the pericardium, pericardial adherences and increasing affection on the heart, pericardiectomy was ultimately performed. Results: Biochemical examination, chest X-ray, computed tomography of thorax and abdomen and cytology report did not reveal any signs of malignancy, connective tissue disease or other infections including extra-pulmonary/pulmonary tuberculosis. However, the pericardial biopsy was Polymerase Chain Reaction positive (PCR) for tuberculosis DNA and showed granulomatous inflammation with necrosis. After 6 months anti-tuberculous therapy, biochemical parameters, LVEF and the clinical condition of the patient were normalized. Conclusion: Tuberculosis can be difficult to diagnose when it only manifests as pericardial effusion especially if the time for exposure is long before the appearance of symptoms and admission.

scholarly journals Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab

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.

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.

Graves’ disease inducing a massive cardiac tamponade

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.

scholarly journals Caso Clínico: Mesotelioma primario de pericardio

2020 ◽  
Vol 12 (3) ◽  
pp. 222-226
Author(s):  
Juan Sebastián Sánchez León ◽  
Irene Lucía Torres Washima ◽  
Anabel Stefanía Cobos Gálvez ◽  
Gladis Margarita Molina Alvarado
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Palliative Treatment ◽  
Pericardial Fluid ◽  
Severe Anemia ◽  
Short Term ◽  
Pericardial Mesothelioma ◽  
The World ◽  
Oncological Diseases ◽  
Low Incidence

BACKGROUND: Primary pericardial mesothelioma is an extremely rare mesodermal tumor, among oncological diseases, with a very low incidence. About 350 cases have been described around the world, most of them diagnosed post-mortem. The short term prognosis is poor, regardless of the treatment, which is mostly palliative. We present a case report regarding this pathology. CASE REPORT: 69 year old patient hospitalized with dyspnea and severe anemia. Complementary workup showed pleural effusion and pericardial effusion. Histopathology report of the pericardial fluid revealed pericardial mesothelioma. EVOLUTION: Due to recurrence of pericardial effusion, it was decided to perform pericardiectomy and left pleurectomy as palliative treatment, to alleviate the patient’s symptoms. Chemotherapy was planned after the procedure, but the patient’s general condition deteriorated severely leading to his death. CONCLUSION: Primary pericardial mesothelioma is a rare tumor, whose symptoms are characterized by the associated pericardial effusion, making the diagnosis difficult due to it low incidence. The prognosis is poor in short- term, and there isn’t an established protocol for the treatment with results that showed improve in mortality. KEYWORDS: MESOTHELIOMA, PERICARDIAL EFFUSION, PERICARDIECTOMY, PLEUROTOMY.

scholarly journals Case Report: Unusual Peritoneopericardial Diaphragmatic Hernia in an 8-Month-Old German Shepherd Dog, Associated With a Pericardial Pseudocyst and Coexisting Severe Pericardial Effusion Resulting in Right-Sided Heart Failure

2021 ◽  
Vol 8 ◽  
Author(s):  
Imke Hennink ◽  
Pia Düver ◽  
Ulrich Rytz ◽  
Felix Meneses ◽  
Melania Moioli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Umbilical Cord ◽  
Umbilical Hernia ◽  
Surgical Repair ◽  
German Shepherd ◽  
German Shepherd Dog ◽  
Peritoneopericardial Diaphragmatic Hernia

Objective: This study aims to describe an unusual peritoneopericardial diaphragmatic hernia (PPDH) in an 8-month-old German shepherd dog, associated with a pericardial pseudocyst and coexisting severe pericardial effusion resulting in right-sided heart failure.Case Summary: An 8-month-old, male, intact, German shepherd dog, was referred for ascites. Echocardiography revealed a severe pericardial effusion with a cyst-like structure within the pericardium and consequently decompensated right-sided heart failure. The ascites was secondary to right-sided heart failure (cardiac tamponade). Computed tomography (CT) of the thorax and abdomen was performed and showed PPDH with severe pericardial effusion and presence of a pericardial cyst-like structure; xyphoid cleft and Y-shaped seventh sternebra; and mild thickening along the cranioventral abdominal wall consistent with scar tissue from the previous umbilical hernia surgical repair. During surgery, the PPDH was corrected, and it was revealed that the remnant of the umbilical cord passed through it, into the pericardium. The cyst-like structure was successfully resected and sent for pathology. Histopathology showed signs of a chronic suppurative inflammation, with absence of a mesothelial or endothelial wall layer, thus consistent with a pseudocyst. Based on tomographic and surgical findings, it is suspected that the pseudocyst, together with the pericardial effusion, evolved by an inflammation of the remnant of the umbilical cord during the umbilical hernia surgical repair 1 month prior to presentation. The underlying PPDH most likely favored the development of the pericardial pseudocyst. However, due to prior antibiotic therapy initiated by the private vet, an infectious origin cannot be ruled out completely.New or Unique Information Provided: There are a few case reports describing PPDH and/or pericardial pseudocysts in veterinary patients, but the current case report is unique, since it describes PPDH associated with a pericardial pseudocyst and coexisting severe pericardial effusion resulting in cardiac tamponade. As far as the authors know, such a case has not been described in veterinary medicine before.

scholarly journals Atypical presentation of cardiac tamponade in pulmonary hypertension , a case report and review of the literature

2021 ◽  
Author(s):  
Zahra Ansari Aval ◽  
Mohsen Mirhosseini ◽  
Sepideh Jafari Naeini
Keyword(s):  
Pulmonary Hypertension ◽  
Case Report ◽  
Systemic Sclerosis ◽  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Young Woman ◽  
Therapeutic Approach ◽  
Left Ventricular ◽  
Atypical Presentation ◽  
Review Of The Literature

A young woman with systemic sclerosis, hypothyroidism and pulmonary hypertension was admitted to our center with massive pericardial effusion and left ventricular (LV) collapse. Despite undergoing successful pericardiocentesis, she passed away a month later. The best therapeutic approach in this situation remains to be determined

scholarly journals Mechanical Cardiac Tamponade as an Initial Presentation of Malignant Lymphoma: Case Report

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Maha Bouziane
Keyword(s):  
Case Report ◽  
Malignant Lymphoma ◽  
Cardiac Tamponade ◽  
Medical History ◽  
Pericardial Fluid ◽  
Initial Presentation ◽  
Neoplastic Disease ◽  
Mediastinal Lymphoma ◽  
Cardiac Filling ◽  
Pericardial Involvement

Cardiac tamponade results from an accumulation of pericardial fluid under pressure, leading to impaired cardiac filling and haemodynamic compromise. In malignant lymphoma, cardiac and pericardial involvement, even though relatively uncommon, can be one early manifestations of this neoplastic disease. We describe a case of a 21 year old female with no medical history, whose first presentation for mediastinal lymphoma was a mechanical cardiac tamponade.

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

1984 ◽  
Vol 2 (6) ◽  
pp. 631-636 ◽  
Author(s):  
S Davis ◽  
P Rambotti ◽  
F Grignani
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Performance Status ◽  
Signs And Symptoms ◽  
Pericardial Fluid ◽  
Complete Control ◽  
Malignant Pericardial Effusion ◽  
Efficacious Treatment ◽  
Clinically Significant ◽  
Premature Removal

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.

An Unusual Presentation of Tuberculous Pericardial Effusion

2009 ◽  
Vol 1 (3) ◽  
pp. 71-72
Author(s):  
Shaheen LNU ◽  
Rajyashri Sharma ◽  
Parvez Anjum ◽  
Pathak Jayshree
Keyword(s):  
Pericardial Effusion ◽  
Cardiac Tamponade ◽  
Pericardial Fluid ◽  
Accurate Diagnosis ◽  
Unusual Presentation ◽  
Severe Bleeding ◽  
Acute Pericarditis ◽  
Prompt Treatment ◽  
Antitubercular Treatment ◽  
Life Saving

ABSTRACT Tuberculosis accounts for upto 4% of acute pericarditis and 7% cases of cardiac tamponade. 19% of women with tuberculosis can present with menorrhagia. Prompt treatment can be life saving but requires accurate diagnosis. We report a case of 25-year-old women who presented with severe bleeding per vaginum for four days. She was in shock. Echocardiography showed moderate pericardial effusion with features of cardiac tamponade. ADA was positive in aspirated pericardial fluid. The patient responded well to antitubercular treatment.

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